U.S. patent application number 14/017823 was filed with the patent office on 2014-07-10 for lipid depot formulations.
This patent application is currently assigned to CAMURUS AB. The applicant listed for this patent is CAMURUS AB. Invention is credited to Ian HARWIGSSON, Fredrik JOABSSON, Markus JOHANSSON, Markus JOHNSSON, Krister THURESSON, Fredrik TIBERG.
Application Number | 20140193347 14/017823 |
Document ID | / |
Family ID | 34982472 |
Filed Date | 2014-07-10 |
United States Patent
Application |
20140193347 |
Kind Code |
A1 |
THURESSON; Krister ; et
al. |
July 10, 2014 |
LIPID DEPOT FORMULATIONS
Abstract
The present invention relates to pre-formulations comprising low
viscosity, non-liquid crystalline, mixtures of: a) at least one
neutral diacyl lipid and/or at least one tocopherol; b) at least
one phospholipid; c) at least one biocompatible, oxygen containing,
low viscosity organic solvent; wherein at least one bioactive agent
is dissolved or dispersed in the low viscosity mixture and wherein
the pre-formulation forms, or is capable of forming, at least one
liquid crystalline phase structure upon contact with an aqueous
fluid. The preformulations are suitable for generating parenteral,
non-parenteral and topical depot compositions for sustained release
of active agents. The invention additionally relates to a method of
delivery of an active agent comprising administration of a
preformulation of the invention, a method of treatment comprising
administration of a preformulation of the invention and the use of
a preformulation of the invention in a method for the manufacture
of a medicament.
Inventors: |
THURESSON; Krister; (Lund,
SE) ; TIBERG; Fredrik; (Lund, SE) ; JOHANSSON;
Markus; (Lund, SE) ; HARWIGSSON; Ian; (Lund,
SE) ; JOABSSON; Fredrik; (Lund, SE) ;
JOHNSSON; Markus; (Lund, SE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
CAMURUS AB |
Lund |
|
SE |
|
|
Assignee: |
CAMURUS AB
Lund
SE
|
Family ID: |
34982472 |
Appl. No.: |
14/017823 |
Filed: |
September 4, 2013 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
13537096 |
Jun 29, 2012 |
8545832 |
|
|
14017823 |
|
|
|
|
11628007 |
Jul 24, 2007 |
8236292 |
|
|
PCT/GB2005/002217 |
Jun 6, 2005 |
|
|
|
13537096 |
|
|
|
|
Current U.S.
Class: |
424/52 ; 424/59;
424/61; 514/11.1; 514/11.4; 514/11.9; 514/178; 514/221; 514/259.41;
514/263.38; 514/329; 514/407; 514/563; 514/635; 514/786 |
Current CPC
Class: |
A61K 31/522 20130101;
A61K 9/006 20130101; A61P 1/02 20180101; A61K 8/553 20130101; A61K
38/23 20130101; A61K 47/10 20130101; A61P 17/02 20180101; A61P
31/10 20180101; A61K 9/12 20130101; A61P 17/00 20180101; A61K
9/0014 20130101; A61K 9/1274 20130101; A61K 31/519 20130101; A61K
47/14 20130101; A61K 2800/10 20130101; A61K 8/375 20130101; A61K
8/498 20130101; A61P 25/34 20180101; A61P 27/06 20180101; A61Q
19/00 20130101; A61K 31/4468 20130101; A61P 5/00 20180101; A61K
8/68 20130101; A61K 31/155 20130101; A61K 9/0002 20130101; A61K
9/0024 20130101; A61K 9/7015 20130101; A61K 31/5685 20130101; A61P
27/02 20180101; A61K 9/0063 20130101; A61K 31/198 20130101; A61K
38/27 20130101; A61K 38/31 20130101; A61P 31/04 20180101; A61K
8/922 20130101; A61K 47/22 20130101; A61K 8/678 20130101; A61K
31/5513 20130101; A61K 31/485 20130101; A61P 31/00 20180101; A61Q
11/00 20130101; A61K 8/37 20130101; A61K 9/0043 20130101; A61K
47/24 20130101; A61Q 3/02 20130101; A61K 8/0295 20130101; A61Q
17/04 20130101; A61K 8/046 20130101; A61K 31/416 20130101; A61K
2800/592 20130101 |
Class at
Publication: |
424/52 ; 514/786;
514/635; 424/59; 514/11.1; 514/407; 424/61; 514/563; 514/11.9;
514/259.41; 514/11.4; 514/329; 514/221; 514/263.38; 514/178 |
International
Class: |
A61K 47/24 20060101
A61K047/24; A61Q 17/04 20060101 A61Q017/04; A61K 8/55 20060101
A61K008/55; A61K 8/37 20060101 A61K008/37; A61K 8/49 20060101
A61K008/49; A61K 38/31 20060101 A61K038/31; A61K 31/416 20060101
A61K031/416; A61Q 3/02 20060101 A61Q003/02; A61K 31/198 20060101
A61K031/198; A61K 38/23 20060101 A61K038/23; A61K 31/519 20060101
A61K031/519; A61K 38/27 20060101 A61K038/27; A61K 31/4468 20060101
A61K031/4468; A61K 31/5513 20060101 A61K031/5513; A61K 31/522
20060101 A61K031/522; A61K 31/5685 20060101 A61K031/5685; A61K
47/22 20060101 A61K047/22; A61K 47/14 20060101 A61K047/14; A61K
31/155 20060101 A61K031/155 |
Foreign Application Data
Date |
Code |
Application Number |
Jun 4, 2004 |
GB |
0412530.8 |
Jan 14, 2005 |
GB |
0500807.3 |
Apr 18, 2005 |
GB |
0507811.8 |
Claims
1. A pre-formulation comprising a low viscosity, non-liquid
crystalline, mixture of: a) at least one neutral diacyl lipid
and/or at least one tocopherol; b) at least one phospholipid; c) at
least one biocompatible, oxygen containing, low viscosity organic
solvent; wherein at least one bioactive agent is optionally
dissolved or dispersed in the low viscosity mixture and wherein the
pre-formulation forms, at least one liquid crystalline phase
structure upon contact with an aqueous fluid.
2. The pre-formulation as claimed in claim 1 wherein said liquid
crystalline phase structure is bioadhesive.
3. The pre-formulation as claimed in claim 1 wherein component a)
consists essentially of diacyl glycerols, especially glycerol
dioleate.
4. The pre-formulation as claimed in claim 1 wherein component a)
consists essentially of at least one tocopherol.
5. The pre-formulation as claimed in claim 1 wherein component a)
consists essentially of a mixture of GDO and tocopherol.
6. The pre-formulation as claimed in claim 1 wherein component b)
is selected from the group consisting of phosphatidylcholine,
phosphatidylethanolamine, phosphatidylserine, phosphatidylinositol
and a mixture thereof.
7. The preformulation as claimed in claim 1 having a viscosity of
0.1 to 5000 mPas.
8. The preformulation as claimed in claim 1 having a molecular
solution, L.sub.2 and/or L.sub.3 phase structure.
9. The preformulation as claimed in claim 1 having a ratio of a) to
b) of between 95:5 and 5:95 by weight.
10. The preformulation as claimed in claim 1 having 0.5 to 50%
component c) by weight of components a)+b)+c).
11. The preformulation as claimed in claim 1 wherein component c)
is selected from the group consisting of alcohol, ketone, ester,
ether, amide, sulphoxide and a mixture thereof.
12. The preformulation as claimed in claim 1 additionally
comprising up to 10% by weight of a)+b) of a charged
amphiphile.
13. The preformulation as claimed in claim 1 wherein said active
agent is present and is selected from the group consisting of drug,
antigen, nutrient, cosmetic, fragrance, flavouring, diagnostic
agent, vitamin, dietary supplement and a mixture thereof.
14. The preformulation as claimed in claim 13 wherein said drug is
selected from the group consisting of hydrophilic small molecule
drug, lipophilic small molecule drug, amphiphilic small molecule
drug, peptide, protein, oligonucleotide and a mixture thereof.
15. The preformulation as claimed in claim 13 wherein said drug is
selected from the group consisting of somatostatin related peptide,
interferon, glucagon-like peptide 1, glucagon-like peptide 2, GnRH
agonist, GnRH antagonist, bisphosphonates bisphosphonate,
chlorhexidine and a mixture thereof.
16. The preformulation as claimed in claim 1 which is administrable
by injection.
17. The preformulation as claimed in claim 1 which is administrable
by spraying, dipping, rinsing, application from a pad or ball
roller, painting, dropping, aerosol spraying or pump spraying.
18. An injectable preformulation as claimed in claim 1 which forms
a depot providing continuous release of active agent for at least
two weeks, wherein said active agent is present and comprises at
least one selected from the group consisting of i. octreotide, ii.
human growth hormone, iii. interferon alpha, iv. leuprolide, and v.
a mixture thereof.
19. The preformulation as claimed in claim 1 which is injectable
and which forms a depot providing continuous release of active
agent for at least two weeks, wherein said active agent is present
and comprises at least one selected from the group consisting of i.
risperidone ii. olanzapine iii. testosterone undecanoate and iv. a
mixture thereof.
20. The formulation as claimed in claim 1 for topical intraoral
administration which forms a bioadhesive, controlled release
product, wherein said active agent is present and comprises at
least one selected from the group consisting of i. benzydamine, ii.
tramadol and iii. a mixture thereof.
21. The preformulation as claimed in claim 1 for topical intraoral
administration for treatment of periodontal and topical infections,
wherein the active agent is present and is chlorhexidine gluconate,
and where the preformulation is applied as a liquid product which
forms a surface gel in situ between 1 second and 5 min after
application.
22. The formulation as claimed in claim 1 for topical intranasal
spray administration which forms a bioadhesive, controlled release
product, wherein said active agent is present and comprises at
least one selected from the group consisting of i. fentanyl ii.
diazepam, and iii. a mixture thereof.
23. The formulation as claimed in claim 1 for ocular
administration, wherein said active agent is present and comprises
at least one selected from the group consisting of diclofenac,
pilocarpine, levocabastine hydrochloride, ketotifen fumarate,
timolol, betaxolol, carteolol, levobunolol, dorzolamide,
brinzolamide, epinephrine, dipivefrin, clonidine, apraclonidine,
brimonidine, pilocarpine, atanoprost, travoprost, bimatoprost,
unoprostone, pilocarpine hydrochloride, dexamethasone,
chloramphenicol, indomethacin and a mixture thereof.
24. The formulation as claimed in claim 1 for non-parenteral
dermatological administration which forms a bioadhesive, controlled
release product, wherein the active agent is present and is
selected from the group consisting of i. acyclovir ii. testosterone
undecanoate, and iii. a mixture thereof.
25. The formulation as claimed in claim 1 for topical
dermatological administration which forms a bioadhesive, controlled
release product, wherein the active agent is present and is
selected from the group consisting of cosmetic agent, fragrance,
flavouring, essential oil, UV absorbing agent and a mixture
thereof.
26. A method of delivery of a bioactive agent to a human or
non-human animal body, this method comprising administering to said
mammalian body a pre-formulation comprising a non-liquid
crystalline, low viscosity mixture of: a) at least one neutral
diacyl lipid and/or at least one tocopherol; b) at least one
phospholipid; c) at least one biocompatible, oxygen containing, low
viscosity organic solvent; and at least one bioactive agent is
dissolved or dispersed in the low viscosity mixture, whereby to
form at least one liquid crystalline phase structure upon contact
with an aqueous fluid in vivo following administration.
27. The method as claimed in claim 26 wherein said preformulation
is a preformulation as claimed in claim 1.
28. The method as claimed in claim 26 wherein said pre-formulation
is administered by a method selected the group consisting of from
subcutaneous injection, intramuscular injection, intra-cavity
injection through tissue, intra-cavity injection into an open
cavity without tissue penetration, spraying, rolling, wiping,
dabbing, painting, rinsing, dropping and a combination thereof.
29. A method for the preparation of a liquid crystalline
composition comprising exposing a pre-formulation comprising a
non-liquid crystalline, low viscosity mixture of: a) at least one
neutral diacyl lipid and/or at least one tocopherol; b) at least
one phospholipid; c) at least one biocompatible, oxygen containing,
low viscosity organic solvent; and optionally at least one
bioactive agent dissolved or dispersed in the low viscosity
mixture, to an aqueous fluid in vivo.
30) The method as claimed in claim 29 wherein said preformulation
is a preformulation as claimed in claim 1.
31) A process for the formation of a pre-formulation suitable for
the administration of a bioactive agent to a mammalian subject,
said process comprising forming a non-liquid crystalline, low
viscosity mixture of a) at least one neutral diacyl lipid and/or at
least one tocopherol; b) at least one phospholipid; c) at least one
biocompatible, oxygen containing low viscosity, organic solvent;
and dissolving or dispersing at least one bioactive agent in the
low viscosity mixture, or in at least one of components a, b or c
prior to forming the low viscosity mixture.
32) The process as claimed in claim 31 wherein said preformulation
is a preformulation as claimed in claim 1.
33-34. (canceled)
35) A method of treatment or prophylaxis of a human or non-human
animal subject comprising administration of a preformulation as
claimed in claim 1.
36) The method of claim 35 for the treatment of a condition
selected from the group consisting of bacterial infection, fungal
infection, skin soreness, eye condition, genital soreness,
infection and condition for the finger and/or toe nails, travel
sickness, addiction including nicotine addiction, periodontal
infection, conjunctivitis, glaucoma, hormone deficiency and hormone
imbalance.
37) The method of claim 35 for prophylaxis against at least one
condition selected from the group consisting of infection during
surgery, infection during implantation, sunburn, infection at the
site of burns, cuts, abrasions, oral infection, genital infection
and infection resulting from activities resulting in exposure to
infective agent.
38. The method of claim 35 for the treatment or prophylaxis of
damaged, sensitized and/or infected mucosa.
39. The method of claim 38 comprising administration of the
preformulation of claim 20.
Description
[0001] This application is a continuation of application Ser. No.
13/537,096, filed Jun. 29, 2012, now allowed, which is a
continuation of application Ser. No. 11/628,007 filed Jul. 24,
2007, now issued U.S. Pat. No. 8,236,292, which in turn is the U.S.
national phase of PCT/GB2005/002217, filed 6 Jun. 2005, which
designated the U.S. and claims priority of GB 0412530.8, filed 4
Jun. 2004; GB 0500807.3, filed 14 Jan. 2005 and GB 0507811.8, filed
18 Apr. 2005, the entire contents of each of which are hereby
incorporated by reference in this application.
[0002] The present invention relates to formulation precursors
(pre-formulations) for the in situ generation of controlled release
lipid compositions. In particular, the invention relates to
pre-formulations in the form of low viscosity mixtures (such as
molecular solutions) of amphiphilic components and at least one
bioactive agent which undergo at least one phase transition upon
exposure to aqueous fluids, such as body fluids, thereby forming a
controlled release matrix which optionally is bioadhesive.
[0003] Many bioactive agents including pharmaceuticals, nutrients,
vitamins and so forth have a "functional window". That is to say
that there is a range of concentrations over which these agents can
be observed to provide some biological effect. Where the
concentration in the appropriate part of the body (e.g. locally or
as demonstrated by serum concentration) falls below a certain
level, no beneficial effect can be attributed to the agent.
Similarly, there is generally an upper concentration level above
which no further benefit is derived by increasing the
concentration. In some cases increasing the concentration above a
particular level results in undesirable or even dangerous
effects.
[0004] Some bioactive agents have a long biological half-life
and/or a wide functional window and thus may be administered
occasionally, maintaining a functional biological concentration
over a substantial period of time (e.g. 6 hours to several days).
In other cases the rate of clearance is high and/or the functional
window is narrow and thus to maintain a biological concentration
within this window regular (or even continuous) doses of a small
amount are required. This can be particularly difficult where
non-oral routes of administration (e.g. parenteral administration)
are desirable. Furthermore, in some circumstances, such as in the
fitting of implants (e.g. joint replacements or oral implants) the
area of desired action may not remain accessible for repeated
administration. In such cases a single administration must provide
active agent at a therapeutic level over the whole period during
which activity is needed.
[0005] Various method have been used and proposed for the sustained
release of biologically active agents. Such methods include
slow-release, orally administered compositions, such as coated
tablets, formulations designed for gradual absorption, such as
transdermal patches, and slow-release implants such as "sticks"
implanted under the skin.
[0006] One method by which the gradual release of a bioactive agent
has been proposed is a so-called "depot" injection. In this method,
a bioactive agent is formulated with carriers providing a gradual
release of active agent over a period of a number of hours or days.
These are often based upon a degrading matrix which gradually
disperses in the body to release the active agent.
[0007] The most common of the established methods of depot
injection relies upon a polymeric depot system. This is typically a
biodegradable polymer such poly (lactic acid) (PLA) and/or poly
(lactic-co-glycolic acid) (PLGA) and may be in the form of a
solution in an organic solvent, a pre-polymer mixed with an
initiator, encapsulated polymer particles or polymer microspheres.
The polymer or polymer particles entrap the active agent and are
gradually degraded releasing the agent by slow diffusion and/or as
the matrix is absorbed. Examples of such systems include those
described in U.S. Pat. No. 4,938,763, U.S. Pat. No. 5,480,656 and
U.S. Pat. No. 6,113,943 and can result in delivery of active agents
over a period of up to several months. These systems do, however,
have a number of limitations including the complexity of
manufacturing and difficulty in sterilising (especially the
microspheres). The local irritation caused by the lactic and/or
glycolic acid which is released at the injection site is also a
noticeable drawback. There is also often quite a complex procedure
to prepare the injection dose from the powder precursor
[0008] From a drug delivery point of view, polymer depot
compositions also have the disadvantage of accepting only
relatively low drug loads and having a "burst/lag" release profile.
The nature of the polymeric matrix, especially when applied as a
solution or pre-polymer, causes an initial burst of drug release
when the composition is first administered. This is followed by a
period of low release, while the degradation of the matrix begins,
followed finally by an increase in the release rate to the desired
sustained profile. This burst/lag release profile can cause the in
vivo concentration of active agent to burst above the functional
window immediately following administration, then drop back through
the bottom of the functional window during the lag period before
reaching a sustained functional concentration. Evidently, from a
functional and toxicological point of view this burst/lag release
profile is undesirable and could be dangerous. It may also limit
the equilibrium concentration which can be provided due to the
danger of adverse effects at the "peak" point.
[0009] Previous depot systems have been sought to address the
problem of burst release. In particular, the use of hydrolysed
polylactic acid and the inclusion of poly lactic acid-polyethylene
glycol block copolymers have been proposed to provide the "low
burst" polymeric system described in U.S. Pat. No. 6,113,943 and
U.S. Pat. No. 6,630,115. These systems provide improved profiles
but the burst/lag effect remains and they do not address other
issues such as the irritation caused by the use of polymers
producing acidic degradation products.
[0010] One alternative to the more established, polymer based,
depot systems was proposed in U.S. Pat. No. 5,807,573. This
proposes a lipid based system of a diacylglycerol, a phospholipid
and optionally water, glycerol, ethylene glycol or propylene glycol
to provide an administration system in the reversed micellar "L2"
phase or a cubic liquid crystalline phase. Since this depot system
is formed from physiologically well tolerated diacyl glycerols and
phospholipids, and does not produce the lactic acid or glycolic
acid degradation products of the polymeric systems, there is less
tendency for this system to produce inflammation at the injection
site. The liquid crystalline phases are, however, of high viscosity
and the L2 phase may also be too viscous for ease of application.
The authors of U.S. Pat. No. 5,807,573 also do not provide any in
vivo assessment of the release profile of the formulation and thus
it is uncertain whether or not a "burst" profile is provided.
[0011] The use of non-lamellar phase structures (such as liquid
crystalline phases) in the delivery of bioactive agents is now
relatively well established. Such structures form when an
amphiphilic compound is exposed to a solvent because the amphiphile
has both polar and apolar groups which cluster to form polar and
apolar regions. These regions can effectively solubilise both polar
and apolar compounds. In addition, many of the structures formed by
amphiphiles in polar and/or apolar solvents have a very
considerable area of polar/apolar boundary at which other
amphiphilic compounds can be adsorbed and stabilised. Amphiphiles
can also be formulated to protect active agents, to at least some
extent, from aggressive biological environments, including enzymes,
and thereby provide advantageous control over active agent
stability and release.
[0012] The formation of non-lamellar regions in the
amphiphile/water, amphiphile/oil and amphiphile/oil/water phase
diagrams is a well known phenomenon. Such phases include liquid
crystalline phases such as the cubic P, cubic D, cubic G and
hexagonal phases, which are fluid at the molecular level but show
significant long-range order, and the L3 phase which comprises a
multiply interconnected bi-continuous network of bilayer sheets
which are non-lamellar but lack the long-range order of the liquid
crystalline phases. Depending upon their curvature of the
amphiphile sheets, these phases may be described as normal (mean
curvature towards the apolar region) or reversed (mean curvature
towards the polar region).
[0013] The non-lamellar liquid crystalline and L3 phases are
thermodynamically stable systems. That is to say, they are not
simply a meta-stable state that will separate and/or reform into
layers, lamellar phases or the like, but are the stable
thermodynamic form of the lipid/solvent mixture.
[0014] While the effectiveness of known lipid depot formulations is
high, there are certain aspects in which the performance of these
is less than ideal. In particular, cubic liquid crystalline phases
proposed are relatively viscous in nature. This makes application
with a standard syringe difficult, and possibly painful to the
patient, and makes sterilisation by filtration impossible because
the composition cannot be passed through the necessary fine-pored
membrane. As a result, the compositions must be prepared under
highly sterile conditions, which adds to the complexity of
manufacturing. Where L2 phases are used, these are generally of
lower viscosity but these may still cause difficulty in application
and allow access to only a small region of the phase diagram.
Specifically, the solvents used in known lipid formulations have
only a limited effect in reducing the viscosity of the mixture.
Water, for example, will induce the formation of a highly viscous
liquid crystalline phase and solvents such as glycerol and glycols
have a high viscosity and do not provide any greatly advantageous
decrease in the viscosity of the composition. Glycols are also
typically toxic or poorly tolerated in vivo and can cause
irritation when applied topically.
[0015] Furthermore, the known lipid compositions in the low-solvent
L2 phase may support only a relatively low level of many bioactive
agents because of their limited solubility in the components of the
mixture in the absence of water. In the presence of water, however,
the formulations adopt a highly viscous cubic liquid crystalline
phase. It would be a clear advantage to provide a depot system that
could be injected at low viscosity and allowed release of the
required concentration of bioactive with a smaller depot
composition volume.
[0016] The known lipid depot compositions also have practical
access to only certain phase structures and compositions because
other mixtures are either too highly viscous for administration
(such as those with high phospholipid concentrations) or run the
risk of separation into two or more separate phases (such as an L2
phase in equilibrium with a phase rich in phospholipid). In
particular, phospholipid concentrations above 50% are not reachable
by known methods and from the phase diagram shown in U.S. Pat. No.
5,807,573 it appears that the desired cubic phase is stable at no
higher than 40% phospholipid. As a result, it has not been possible
in practice to provide depot compositions of high phospholipid
concentration or having a hexagonal liquid crystalline phase
structure.
[0017] The present inventors have now established that by providing
a pre-formulation comprising certain amphiphilic components, at
least one bioactive agent and a biologically tolerable solvent,
especially in a low viscosity phase such as molecular solution, the
pre-formulation may be generated addressing many of the shortfalls
of previous depot formulations. In particular, the pre-formulation
is easy to manufacture, may be sterile-filtered, it has low
viscosity (allowing easy and less painful administration), allows a
high level of bioactive agent to be incorporated (thus allowing a
smaller amount of composition to be used) and/or forms a desired
non-lamellar depot composition in vivo having a controllable
"burst" or "non-burst" release profile. The compositions are also
formed from materials that are non-toxic, biotolerable and
biodegradable. Furthermore, the pre-formulation is suitable for the
formation of depot compositions following parenteral administration
and also following non-parenteral (e.g. topical) administration to
body cavities and/or surfaces of the body or elsewhere.
[0018] In a first aspect, the present invention thus provides a
pre-formulation comprising a low viscosity mixture of:
[0019] a) at least one neutral diacyl lipid and/or a
tocopherol;
[0020] b) at least one phospholipid;
[0021] c) at least one biocompatible, (preferably oxygen
containing) organic solvent;
[0022] wherein at least one bioactive agent is dissolved or
dispersed in the low viscosity mixture and wherein the
pre-formulation forms, or is capable of forming, at least one
liquid crystalline phase structure upon contact with an aqueous
fluid.
[0023] Generally, the aqueous fluid will be a body fluid such as
fluid from a mucosal surface, tears, sweat, saliva,
gastro-intestinal fluid, extra-vascular fluid, extracellular fluid,
interstitial fluid or plasma, and the pre-formulation will form a
liquid crystalline phase structure when contacted with a body
surface, area or cavity (e.g. in vivo) upon contact with the
aqueous body fluid. The pre-formulation of the invention will
generally not contain any significant quantity of water prior to
administration.
[0024] In a second aspect of the invention, there is also provided
a method of delivery of a bioactive agent to a human or non-human
animal (preferably mammalian) body, this method comprising
administering (preferably parenterally) a pre-formulation
comprising a low viscosity mixture of:
[0025] a) at least one neutral diacyl lipid and/or a
tocopherol;
[0026] b) at least one phospholipid;
[0027] c) at least one biocompatible, (preferably oxygen
containing) organic solvent;
[0028] and at least one bioactive agent is dissolved or dispersed
in the low viscosity mixture, whereby to form at least one liquid
crystalline phase structure upon contact with an aqueous fluid in
vivo following administration. Preferably, the pre-formulation
administered in such a method is a pre-formulation of the invention
as described herein.
[0029] The method of administration suitable for the above method
of the invention will be a method appropriate for the condition to
be treated and the bioactive agent used. A parenteral depot will
thus be formed by parenteral (e.g. subcutaneous or intramuscular)
administration while a bioadhesive non-parenteral (e.g. topical)
depot composition may be formed by administration to the surface of
skin, mucous membranes and/or nails, to opthalmological, nasal,
oral or internal surfaces or to cavities such as nasal, rectal,
vaginal or buccal cavities, the periodontal pocket or cavities
formed following extraction of a natural or implanted structure or
prior to insertion of an implant (e.g a joint, stent, cosmetic
implant, tooth, tooth filling or other implant).
[0030] In a further aspect, the present invention also provides a
method for the preparation of a liquid crystalline composition
(especially a depot composition) comprising exposing a
pre-formulation comprising a low viscosity mixture of:
[0031] a) at least one neutral diacyl lipid and/or a
tocopherol;
[0032] b) at least one phospholipid;
[0033] c) at least one biocompatible (preferably oxygen
containing), organic solvent;
[0034] and at least one bioactive agent dissolved or dispersed in
the low viscosity mixture, to an aqueous fluid (particularly in
vivo and/or particularly a body fluid as indicated herein).
Preferably the pre-formulation administered is a pre-formulation of
the present invention as described herein. The exposure to a fluid
"in vivo" may evidently be internally within the body or a body
cavity, or may be at a body surface such as a skin surface,
depending upon the nature of the composition.
[0035] The liquid crystalline composition formed in this method is
preferably bioadhesive as described herein.
[0036] In a still further aspect the present invention provides a
process for the formation of a pre-formulation suitable for the
administration of a bioactive agent to a (preferably mammalian)
subject, said process comprising forming a low viscosity mixture
of
[0037] a) at least one neutral diacyl lipid and/or a
tocopherol;
[0038] b) at least one phospholipid;
[0039] c) at least one biocompatible (preferably oxygen
containing), organic solvent;
[0040] and dissolving or dispersing at least one bioactive agent in
the low viscosity mixture, or in at least one of components a, b or
c prior to forming the low viscosity mixture. Preferably the
pre-formulation so-formed is a formulation of the invention as
described herein.
[0041] In a yet still further aspect the present invention provides
the use of a low viscosity mixture of:
[0042] a) at least one neutral diacyl lipid and/or a
tocopherol;
[0043] b) at least one phospholipid;
[0044] c) at least one biocompatible (preferably oxygen
containing), organic solvent;
[0045] wherein at least one bioactive agent is dissolved or
dispersed in the low viscosity mixture in the manufacture of a
pre-formulation for use in the sustained administration of said
active agent, wherein said pre-formulation is capable of forming at
least one liquid crystalline phase structure upon contact with an
aqueous fluid.
[0046] As used herein, the term "low viscosity mixture" is used to
indicate a mixture which may be readily administered to a subject
and in particular readily administered by means of a standard
syringe and needle arrangement. This may be indicated, for example
by the ability to be dispensed from a 1 ml disposable syringe
through a 22 awg (or a 23 gauge) needle by manual pressure. In a
particularly preferred embodiment, the low viscosity mixture should
be a mixture capable of passing through a standard sterile
filtration membrane such as a 0.22 .mu.m syringe filter. In other
preferred embodiments, a similar functional definition of a
suitable viscosity can be defined as the viscosity of a
pre-formulation that can be sprayed using a compression pump or
pressurized spray device using conventional spray equipment.
[0047] A typical range of suitable viscosities would be, for
example, 0.1 to 5000 mPas, preferably 1 to 1000 mPas at 20.degree.
C.
[0048] It has been observed that by the addition of small amounts
of low viscosity solvent, as indicated herein, a very significant
change in viscosity can be provided. As indicated in FIG. 2, for
example, the addition of only 5% solvent can reduce viscosity
100-fold and addition of 10% may reduce the viscosity up to 10,000
fold. In order to achieve this non-linear, synergistic effect, in
lowering viscosity it is important that a solvent of appropriately
low viscosity and suitable polarity be employed. Such solvents
include those described herein infra.
[0049] Particularly preferred examples of low viscosity mixtures
are molecular solutions and/or isotropic phases such as L2 and/or
L3 phases. As describe above, the L3 is a non-lamellar phase of
interconnected sheets which has some phase structure but lacks the
long-range order of a liquid crystalline phase. Unlike liquid
crystalline phases, which are generally highly viscous, L3 phases
are of lower viscosity. Obviously, mixtures of L3 phase and
molecular solution and/or particles of L3 phase suspended in a bulk
molecular solution of one or more components are also suitable. The
L2 phase is the so-called "reversed micellar" phase or
microemulsion. Most preferred low viscosity mixtures are molecular
solutions, L3 phases and mixtures thereof. L2 phases are less
preferred, except in the case of swollen L.sub.2 phases as
described below.
[0050] The present invention provides a pre-formulation comprising
components a, b, c and at least one bioactive agent as indicated
herein. One of the considerable advantages of the pre-formulations
of the invention is that components a and b may be formulated in a
wide range of proportions. In particular, it is possible to prepare
and use pre-formulations of the present invention having a much
greater proportion of phospholipid to neutral, diacyl lipid and/or
tocopherol than was previously achievable without risking phase
separation and/or unacceptably high viscosities in the
pre-formulation. The weight ratios of components a:b may thus be
anything from 5:95 right up to 95:5. Preferred ratios would
generally be from 90:10 to 20:80 and more preferably from 85:15 to
30:70. In one preferred embodiment of the invention, there is a
greater proportion of component b than component a. That is, the
weight ratio a:b is below 50:50, e.g. 48:52 to 2:98, preferably,
40:60 to 10:90 and more preferably 35:65 to 20:80.
[0051] The amount of component c in the pre-formulations of the
invention will be at least sufficient to provide a low viscosity
mixture (e.g. a molecular solution, see above) of components a, b
and c and will be easily determined for any particular combination
of components by standard methods. The phase behaviour itself may
be analysed by techniques such as visual observation in combination
with polarized light microscopy, nuclear magnetic resonance, and
cryo-transmission electron microscopy (cryo-TEM) to look for
solutions, L2 or L3 phases, or liquid crystalline phases. Viscosity
may be measured directly by standard means. As described above, an
appropriate practical viscosity is that which can effectively be
syringed and particularly sterile filtered. This will be assessed
easily as indicated herein. The maximum amount of component c to be
included will depend upon the exact application of the
pre-formulation but generally the desired properties will be
provided by any amount forming a low viscosity mixture (e.g. a
molecular solution, see above) and/or a solution with sufficiently
low viscosity. Since the administration of unnecessarily large
amounts of solvent to a subject is generally undesirable the amount
of component c will typically be limited to no more than ten times
(e.g. three times) the minimum amount required to form a low
viscosity mixture, preferably no more than five times and most
preferably no more than twice this amount. The composition of the
present invention may, however, contain a greater quantity of
solvent than would be acceptable in an immediate dosage
composition. This is because the process by which the active agents
are slowly released (e.g. formation of shells of liquid crystalline
phase se described herein) also serve to retard the passage of
solvent from the composition. As a result, the solvent is released
over some time (e.g. minutes or hours) rather than instantaneously
and so can be better tolerated by the body.
[0052] Higher proportions of solvent may also be used for
non-parenteral (e.g. topical) applications, especially to body
surfaces, where the solvent will be lost by evaporation rather than
absorbed into the body. For such applications up to 100 times the
minimum amount of solvent may be used (e.g. up to 95% by weight of
the composition, preferably up to 80% by weight and more preferably
up to 50% by weight), especially where a very thin layer of the
resulting non-parenteral depot is desired.
[0053] Where the compositions of the invention are formulated as
(non-parenteral) aerosol spray compositions (e.g. for topical or
systemic delivery of an active), the composition may also comprise
a propellant. Such compositions may also include a high proportion
of solvent component c), as considered above, since much of the
solvent will evaporate when the composition is dispensed.
[0054] Suitable propellants are volatile compounds which will mix
with the composition of the invention under the pressure of the
spray dispenser, without generating high viscosity mixtures. They
should evidently have acceptable biocompatibility. Suitable
propellants will readily be identified by simple testing and
examples include hydrocarbons (especially C.sub.1 to C.sub.4
hydrocarbons), carbon dioxide and nitrogen. Volatile
hydrofluorocarbons such as HFCs 134, 134a, 227ea and/or 152a may
also be suitable.
[0055] As a general guide, the weight of component c will typically
be around 0.5 to 50% of the total weight of the a-b-c solution.
This proportion is preferably (especially for injectable depots) 2
to 30% and more preferably 5 to 20% by weight.
[0056] Component "a" as indicated herein is a neutral lipid
component comprising a polar "head" group and also non-polar "tail"
groups. Generally the head and tail portions of the lipid will be
joined by an ester moiety but this attachment may be by means of an
ether, an amide, a carbon-carbon bond or other attachment.
Preferred polar head groups are non-ionic and include polyols such
as glycerol, diglycerol and sugar moieties (such as inositol and
glucosyl based moieties); and esters of polyols, such as acetate or
succinate esters. Preferred polar groups are glycerol and
diglycerol, especially glycerol.
[0057] In one preferred aspect, component a is a diacyl lipid in
that it has two non-polar "tail" groups. This is generally
preferable to the use of mono-acyl ("lyso") lipids because these
are typically less well tolerated in vivo. The two non-polar groups
may have the same or a differing number of carbon atoms and may
each independently be saturated or unsaturated. Examples of
non-polar groups include C.sub.6-C.sub.32 alkyl and alkenyl groups,
which are typically present as the esters of long chain carboxylic
acids. These are often described by reference to the number of
carbon atoms and the number of unsaturations in the carbon chain.
Thus, CX:Z indicates a hydrocarbon chain having X carbon atoms and
Z unsaturations. Examples particularly include caproyl (C6:0),
capryloyl (C8:0), capryl (C10:0), lauroyl (C12:0), myristoyl
(C14:0), palmitoyl (C16:0), phytanoly (C16:0), palmitoleoyl
(C16:1), stearoyl (C18:0), oleoyl (C18:1), elaidoyl (C18:1),
linoleoyl (C18:2), linolenoyl (C18:3), arachidonoyl (C20:4),
behenoyl (C22:0) and lignoceroyl (C24:9) groups. Thus, typical
non-polar chains are based on the fatty acids of natural ester
lipids, including caproic, caprylic, capric, lauric, myristic,
palmitic, phytanic, palmitolic, stearic, oleic, elaidic, linoleic,
linolenic, arachidonic, behenic or lignoceric acids, or the
corresponding alcohols. Preferable non-polar chains are palmitic,
stearic, oleic and linoleic acids, particularly oleic acid.
[0058] The diacyl lipid, when used as all or part of component "a",
may be synthetic or may be derived from a purified and/or
chemically modified natural sources such as vegetable oils.
Mixtures of any number of diacyl lipids may be used as component a.
Most preferably this component will include at least a portion of
diacyl glycerol (DAG), especially glycerol dioleate (GDO). In one
favoured embodiment, component a consists of DAGs. These may be a
single DAG or a mixture of DAGs. A highly preferred example is DAG
comprising at least 50%, preferably at least 80% and even
comprising substantially 100% GDO.
[0059] An alternative or additional highly preferred class of
compounds for use as all or part of component a are tocopherols. As
used herein, the term "a tocopherol" is used to indicate the
non-ionic lipid tocopherol, often known as vitamin E, and/or any
suitable salts and/or analogues thereof. Suitable analogues will be
those providing the phase-behaviour, lack of toxicity, and phase
change upon exposure to aqueous fluids, which characterise the
compositions of the present invention. Such analogues will
generally not form liquid crystalline phase structures as a pure
compound in water. The most preferred of the tocopherols is
tocopherol itself, having the structure below. Evidently,
particularly where this is purified from a natural source, there
may be a small proportion of non-tocopherol "contaminant" but this
will not be sufficient to alter the advantageous phase-behaviour or
lack of toxicity. Typically, a tocopherol will contain no more than
10% of non-tocopherol-analogue compounds, preferably no more than
5% and most preferably no more than 2% by weight.
##STR00001##
[0060] In a further advantageous embodiment of the invention,
component a) consists essentially of tocopherols, in particular
tocopherol as shown above.
[0061] A preferred combination of constituents for component a) is
a mixture of at least one DAG (e.g. GDO) with at least one
tocopherol. Such mixtures include 2:98 to 98:2 by weight
tocopherol:GDO, e.g.10:90 to 90:10 tocopherol:GDO and especially
20:80 to 80:20 of these compounds. Similar mixtures of tocopherol
with other DAGs are also suitable.
[0062] Component "b" in the present invention is at least one
phospholipid. As with component a, this component comprises a polar
head group and at least one non-polar tail group. The difference
between components a and b lies principally in the polar group. The
non-polar portions may thus suitably be derived from the fatty
acids or corresponding alcohols considered above for component a.
It will typically be the case that the phospholipid will contain
two non-polar groups, although one or more constituents of this
component may have one non-polar moiety. Where more than one
non-polar group is present these may be the same or different.
[0063] Preferred phospholipid polar "head" groups include
phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine
and phosphatidylinositol. Most preferred is phosphatidylcholine
(PC). In a preferred embodiment, component b) thus consists of at
least 50% PC, preferably at least 70% PC and most preferably at
least 80% PC. Component b) may consist essentially of PC.
[0064] The phospholipid portion, even more suitably than any diacyl
lipid portion, may be derived from a natural source. Suitable
sources of phospholipids include egg, heart (e.g. bovine), brain,
liver (e.g. bovine) and plant sources including soybean. Such
sources may provide one or more constituents of component b, which
may comprise any mixture of phospholipids.
[0065] Since the pre-formulations of the invention are to be
administered to a subject for the controlled release of an active
agent, it is preferable that the components a and b are
biocompatible. In this regard, it is preferable to use, for
example, diacyl lipids and phospholipids rather than mono-acyl
(lyso) compounds. A notable exception to this is tocopherol, as
described above. Although having only one alkyl chain, this is not
a "lyso" lipid in the convention sense. The nature of tocopherol as
a well tolerated essential vitamin evidently makes it highly
suitable in biocompatibility.
[0066] It is furthermore most preferable that the lipids and
phospholipids of components a and b are naturally occurring
(whether they are derived from a natural source or are of synthetic
origin). Naturally occurring lipids tend to cause lesser amounts of
inflammation and reaction from the body of the subject. Not only is
this more comfortable for the subject but it may increase the
residence time of the resulting depot composition, especially for
parenteral depots, since less immune system activity is recruited
to the administration site. In certain cases it may, however, be
desirable to include a portion of a non-naturally-occurring lipid
in components a and/or b. This might be, for example an "ether
lipid" in which the head and tail groups are joined by an ether
bond rather than an ester. Such non-naturally-occurring lipids may
be used, for example, to alter the rate of degradation of the
resulting depot-composition by having a greater or lesser
solubility or vulnerability to breakdown mechanisms present at the
site of active agent release. Although all proportions fall within
the scope of the present invention, generally, at least 50% of each
of components a and b will be naturally occurring lipids. This will
preferably be at least 75% and may be up to substantially 100%.
[0067] Two particularly preferred combinations of components a and
b are GDO with PC and tocopherol with PC, especially in the region
30-90 wt % GDO/tocopherol, 10-60 wt % PC and 1-30% solvent
(especially ethanol, NMP and/or ispropanol).
[0068] In addition to amphiphilic components a and b, the
pre-formulations of the invention may also contain additional
amphiphilic components at relatively low levels. In one embodiment
of the invention, the pre-formulation contains up to 10% (by weight
of components a and b) of a charged amphiphile, particularly an
anionic amphiphile such as a fatty acid. Preferred fatty acids for
this purpose include caproic, caprylic, capric, lauric, myristic,
palmitic, phytanic, palmitolic, stearic, oleic, elaidic, linoleic,
linolenic, arachidonic, behenic or lignoceric acids, or the
corresponding alcohols. Preferable fatty acids are palmitic,
stearic, oleic and linoleic acids, particularly oleic acid. It is
particularly advantageous that this component be used in
combination with a cationic peptide active agent (see below). The
combination of an anionic lipid and a cationic peptide is believed
to provide a sustained release composition of particular value.
This may in part be due to increased protection of the peptide from
the degradative enzymes present in vivo.
[0069] Component "c" of the pre-formulations of the invention is an
oxygen containing organic solvent. Since the pre-formulation is to
generate a depot composition following administration (e.g. in
vivo), upon contact with an aqueous fluid, it is desirable that
this solvent be tolerable to the subject and be capable of mixing
with the aqueous fluid, and/or diffusing or dissolving out of the
pre-formulation into the aqueous fluid. Solvents having at least
moderate water solubility are thus preferred.
[0070] In a preferred version, the solvent is such that a
relatively small addition to the composition comprising a and b,
i.e. below 20%, or more preferably below 10%, give a large
viscosity reductions of one order of magnitude or more. As
described herein, the addition of 10% solvent can give a reduction
of two, three or even four orders of magnitude in viscosity over
the solvent-free composition, even if that composition is a
solution or L.sub.2 phase containing no solvent, or an unsuitable
solvent such as water (subject to the special case considered
below), or glycerol.
[0071] Typical solvents suitable for use as component c include at
least one solvent selected from alcohols, ketones, esters
(including lactones), ethers, amides and sulphoxides. Examples of
suitable alcohols include ethanol, isopropanol and glycerol formal.
Monools are preferred to diols and polyols. Where diols or polyols
are used, this is preferably in combination with an at least equal
amount of monool or other preferred solvent. Examples of ketones
include acetone, n-methylpyrrolidone (NMP), 2-pyrrolidone, and
propylene carbonate. Suitable ethers include diethylether,
glycofurol, diethylene glycol monoethyl ether, dimethylisobarbide,
and polyethylene glycols. Suitable esters include ethyl acetate and
isopropyl acetate and dimethyl sulphide is as suitable sulphide
solvent. Suitable amides and sulphoxides include dimethylacetamide
(DMA) and dimethylsulphoxide (DMSO), respectively. Less preferred
solvents include dimethyl isosorbide, tetrahydrofurfuryl alcohol,
diglyme and ethyl lactate.
[0072] Since the pre-formulations are to be administered to a
living subject, it is necessary that the solvent component c is
sufficiently biocompatible. The degree of this biocompatibility
will depend upon the application method and since component c may
be any mixture of solvents, a certain amount of a solvent that
would not be acceptable in large quantities may evidently be
present. Overall, however, the solvent or mixture forming component
c must not provoke unacceptable reactions from the subject upon
administration. Generally such solvents will be hydrocarbons or
preferably oxygen containing hydrocarbons, both optionally with
other substituents such as nitrogen containing groups. It is
preferable that little or none of component c contains halogen
substituted hydrocarbons since these tend to have lower
biocompatibility. Where a portion of halogenated solvent such as
dichloromethane or chloroform is necessary, this proportion will
generally be minimised. Where the depot composition is to be formed
non-parenterally a greater range of solvents may evidently be used
than where the depot is to be parenteral.
[0073] Component c as used herein may be a single solvent or a
mixture of suitable solvents but will generally be of low
viscosity. This is important because one of the key aspects of the
present invention is that it provides preformulations that are of
low viscosity and a primary role of a suitable solvent is to reduce
this viscosity. This reduction will be a combination of the effect
of the lower viscosity of the solvent and the effect of the
molecular interactions between solvent and lipid composition. One
observation of the present inventors is that the oxygen-containing
solvents of low viscosity described herein have highly advantageous
and unexpected molecular interactions with the lipid parts of the
composition, thereby providing a non-linear reduction in viscosity
with the addition of a small volume of solvent.
[0074] The viscosity of the "low viscosity" solvent component c
(single solvent or mixture) should typically be no more than 18
mPas at 20.degree. C. This is preferably no more than 15 mPas, more
preferably no more than 10 mPas and most preferably no more than 7
mPas at 20.degree. C.
[0075] The solvent component c will generally be at least partially
lost upon in vivo formation of the depot composition, or diluted by
absorption of water from the surrounding air and/or tissue. It is
preferable, therefore, that component c be at least to some extent
water miscible and/or dispersible and at least should not repel
water to the extent that water absorption is prevented. In this
respect also, oxygen containing solvents with relatively small
numbers of carbon atoms (for example up to 10 carbons, preferably
up to 8 carbons) are preferred. Obviously, where more oxygens are
present a solvent will tend to remain soluble in water with a
larger number of carbon atoms. The carbon to heteroatom (e.g. N, O,
preferably oxygen) ratio will thus often be around 1:1 to 6:1,
preferably 2:1 to 4:1. Where a solvent with a ratio outside one of
these preferred ranges is used then this will preferably be no more
than 75%, preferably no more than 50%, in combination with a
preferred solvent (such as ethanol). This may be used, for example
to decrease the rate of evaporation of the solvent from the
pre-formulation in order to control the rate of liquid crystalline
depot formation.
[0076] A further advantage of the present pre-formulations is that
a higher level of bioactive agent may be incorporated into the
system. In particular, by appropriate choice of components a-c
(especially c), high levels of active agent may be dissolved or
suspended in the pre-formulations. Generally, the lipid components
in the absence of water are relatively poorly solubilising but in
the presence of water form phases too viscous to administer easily.
Higher proportions of bioactive agent may be included by use of
appropriate solvents as component c and this level will either
dissolve in the depot composition as it forms in situ or may form
microdrops or microcrystals which will gradually dissolve and
release active agent. A suitable choice of solvent will be possible
by routine experimentation within the guidelines presented
herein.
[0077] The pre-formulations of the present invention typically do
not contain significant amounts of water. Since it is essentially
impossible to remove every trace of water from a lipid composition,
this is to be taken as indicating that only such minimal trace of
water exists as cannot readily be removed. Such an amount will
generally be less than 1% by weight, preferably less that 0.5% by
the weight of the pre-formulation. In one preferred aspect, the
pre-formulations of the invention do not contain glycerol, ethylene
glycol or propylene glycol and contain no more than a trace of
water, as just described.
[0078] There is, however, a certain embodiment of the present
invention in which higher proportions of water may be tolerated.
This is where water is present as a part of the solvent component
in combination with an additional water-miscible component c
(single solvent or mixture). In this embodiment, up to 10 wt %
water may be present providing that at least 3 wt %, preferably at
least 5% and more preferably at least 7 wt % component c is also
present, that component c is water miscible, and that the resulting
preformulation remains non-viscous and thus does not form a liquid
crystalline phase. Generally there will be a greater amount of
component c) by weight than the weight of water included in the
preformulation. Most suitable solvents of use with water in this
aspect of the invention include ethanol, isopropyl alcohol, NMP,
acetone and ethyl acetate.
[0079] The pre-formulations of the present invention contain one or
more bioactive agents (described equivalently as "active agents"
herein). Active agents may be any compound having a desired
biological or physiological effect, such as a protein, drug,
antigen, nutrient, cosmetic, fragrance, flavouring, diagnostic,
pharmaceutical, vitamin, or dietary agent and will be formulated at
a level sufficient to provide an in vivo concentration at a
functional level (including local concentrations for topical
compositions). Under some circumstances one or more of components
a, b and/or c may also be an active agent, although it is preferred
that the active agent should not be one of these components. Most
preferred active agents are pharmaceutical agents including drugs,
vaccines, and diagnostic agents.
[0080] Drug agents that may be delivered by the present invention
include drugs which act on cells and receptors, peripheral nerves,
adrenergic receptors, cholinergic receptors, the skeletal muscles,
the cardiovascular system, smooth muscles, the blood circulation
system, endocrine and hormone system, blood circulatory system,
synoptic sites, neuroeffector junctional sites, the immunological
system, the reproductive system, the skeletal system, autacoid
system, the alimentary and excretory systems, the histamine system,
and the central nervous system.
[0081] Examples of drugs which may be delivered by the composition
of the present invention include, but are not limited to,
antibacterial agents such as .beta.-lactams or macrocyclic peptide
antibiotics, anti fungal agents such as polyene macrolides (e.g.
amphotericin B) or azole antifungals, anticancer and/or anti viral
drugs such as nucleoside analogues, paclitaxel and derivatives
thereof, anti inflammatorys, such as non-steroidal anti
inflammatory drugs and corticosteroids, cardiovascular drugs
including cholesterol lowering and blood-pressure lowing agents,
analgesics, antipsychotics and antidepressants including seritonin
uptake inhibitors, prostaglandins and derivatives, vaccines, and
bone modulators. Diagnostic agents include radionuclide labelled
compounds and contrast agents including X-ray, ultrasound and MRI
contrast enhancing agents. Nutrients include vitamins, coenzymes,
dietary supplements etc.
[0082] Particularly suitable active agents include those which
would normally have a short residence time in the body due to rapid
breakdown or excretion and those with poor oral bioavailability.
These include peptide, protein and nucleic acid based active
agents, hormones and other naturally occurring agents in their
native or modified forms. By administering such agents in the form
of a depot composition formed from the pre-formulation of the
present invention, the agents are provided at a sustained level for
a length of time which may stretch to days, weeks or even several
months in spite of having rapid clearance rates. This offers
obvious advantages in terms of stability and patient compliance
over dosing multiple times each day for the same period. In one
preferred embodiment, the active agent thus has a biological half
life (upon entry into the blood stream) of less than 1 day,
preferably less than 12 hours and more preferably less than 6
hours. In some cases this may be as low as 1-3 hours or less.
Suitable agents are also those with poor oral bioavailability
relative to that achieved by injection, for where the active agent
also or alternatively has a bioavailability of below 0.1%,
especially below 0.05% in oral formulations.
[0083] Peptide and protein based active agents include human and
veterinary drugs selected from the group consisting of
adrenocorticotropic hormone (ACTH) and its fragments, angiotensin
and its related peptides, antibodies and their fragments, antigens
and their fragments, atrial natriuretic peptides, bioadhesive
peptides, Bradykinins and their related peptides, calcitonins and
their related peptides, cell surface receptor protein fragments,
chemotactic peptides, cyclosporins, cytokines, Dynorphins and their
related peptides, endorphins and P-lidotropin fragments, enkephalin
and their related proteins, enzyme inhibitors, immunostimulating
peptides and polyaminoacids, fibronectin fragments and their
related peptides, gastrointestinal peptides,
gonadotrophin-releasing hormone (GnRH) agonists and antagonist,
glucagons like peptides, growth hormone releasing peptides,
immunostimulating peptides, insulins and insulin-like growth
factors, interleukins, luthenizing hormone releasing hormones
(LHRH) and their related peptides, melanocyte stimulating hormones
and their related peptides, nuclear localization signal related
peptides, neurotensins and their related peptides, neurotransmitter
peptides, opioid peptides, oxytocins, vasopressins and their
related peptides, parathyroid hormone and its fragments, protein
kinases and their related peptides, somatostatins and their related
peptides, substance P and its related peptides, transforming growth
factors (TGF) and their related peptides, tumor necrosis factor
fragments, toxins and toxoids and functional peptides such as
anticancer peptides including angiostatins, antihypertension
peptides, anti-blood clotting peptides, and antimicrobial peptides;
selected from the group consisting of proteins such as
immunoglobulins, angiogenins, bone morphogenic proteins,
chemokines, colony stimulating factors (CSF), cytokines, growth
factors, interferons (Type I and II), interleukins, leptins,
leukaemia inhibitory factors, stem cell factors, transforming
growth factors and tumor necrosis factors.
[0084] A further considerable advantage of the depot compositions
of the present invention is that active agents are released
gradually over long periods without the need for repeated dosing.
The composition are thus highly suitable for situations where
patient compliance is difficult, unreliable or where a level dosage
is highly important, such as mood-altering actives, those actives
with a narrow therapeutic window, and those administered to
children or to people who's lifestyle is incompatible with a
reliable dosing regime. Also for "lifestyle" actives where the
inconvenience of repeated dosing might outweigh the benefit of the
active. Particular classes of actives for which this aspect offers
a particular advantage include contraceptives, hormones including
contraceptive hormones, and particularly hormones used in children
such as growth hormone, anti-addictive agents, supplements such as
vitamin or mineral supplements, anti-depressants and
anticonvulsants
[0085] Cationic peptides are particularly suitable for use where a
portion of the pre-formulation comprises an anionic amphiphile such
as a fatty acid. In this embodiment, preferred peptides include
octreotide, lanreotide, calcitonin, oxytocin, interferon-beta and
-gamma, interleukins 4, 5, 7 and 8 and other peptides having an
isoelectric point above pH 7, especially above pH 8.
[0086] In one preferred aspect of the present invention, the
composition of the invention is such that an I.sub.2 phase, or a
mixed phase including I.sub.2 phase is formed upon exposure to
aqueous fluids and a polar active agent is included in the
composition. Particularly suitable polar active agents include
peptide and protein actives, oligo nucleotides, and small water
soluble actives, including those listed above. Of particular
interest in this aspect are the peptide octreotide and other
somatostatin related peptides, interferons alpha and beta,
glucagon-like peptides 1 and 2, luprorelin and other GnRH agonist,
abarelix and other GnRH antagonists, interferon alpha and beta,
zolendronate and ibandronate and other bisphosphonates, and polar
active chlorhexidine (e.g. chlorhexidine digluconate or
chlorhexidine dihydrochloride).
[0087] A particular advantage of the present invention when used in
combination with protein/peptide active agents is that aggregation
of the active agent is suppressed. In one preferred embodiment, the
present invention thus provides a depot precursor and particularly
a depot composition as described herein comprising at least one
peptide (e.g. antibody) or protein active agent wherein no more
than 5% of the active agent is in aggregated form. Preferably no
more than 3% is aggregated and most preferably no more than 2%
(especially less than 2%) is in aggregated form. This stabilisation
of non-aggregated protein is highly advantageous from the point of
view of high effectiveness, low side effects and predictable
absorption profile. Furthermore, it is increasingly expected that
protein/peptide therapeutics will have low levels of protein
aggregation in order to secure regulatory approval.
[0088] The amount of bioactive agent to be formulated with the
pre-formulations of the present invention will depend upon the
functional dose and the period during which the depot composition
formed upon administration is to provide sustained release.
Typically, the dose formulated for a particular agent will be
around the equivalent of the normal daily dose multiplied by the
number of days the formulation is to provide release. Evidently
this amount will need to be tailored to take into account any
adverse effects of a large dose at the beginning of treatment and
so this will generally be the maximum dose used. The precise amount
suitable in any case will readily be determined by suitable
experimentation.
[0089] In one embodiment, the pre-formulations of the present
invention will generally be administered parenterally. This
administration will generally not be an intra-vascular method but
will preferably be subcutaneous intracavitary or intramuscular.
Typically the administration will be by injection, which term is
used herein to indicate any method in which the formulation is
passed through the skin, such as by needle, catheter or needle-less
injector.
[0090] In parenteral (especially sub cutaneous) depot precursors,
preferred active agents are those suitable for systemic
administration including antibacterials (including amicacin,
monocycline anddoxycycline), local and systemic anagesics
(including bupivacain, tramadol, fentanyl, morphine, hydromorphone,
methadone, oxycodone, codeine, asperine, acetaminophen), NSAIDS
(such as ibuprofene, naproxene, keteprofene, indomethansine,
sulindac, tolmethin, salysylic acids such as salisylamide,
diflunisal), Cox1 or Cox2 inhibitors (such as celecoxib, rofecoxib,
valdecoxib) anticancer agents (including octreotide, lanreotide,
buserelin, luprorelin, goserelin, triptorelin, avorelin, deslorein,
abarelix, degarelix, fulvestrant, interferon alpha, interferon
beta, darbepoetin alpha, epoetin alpha, beta, delta, and
paclitaxel), antipsychotics (like bromperidol, risperidone,
olanzapine, iloperidone, paliperadone, pipotiazine and
zuclopenthixol), antivirals, anticonvulsants (for instance
tiagabine topiramate or gabapentin) or nicotine, hormones (such as
testosterone, and testosterone undecanoate, medroxyprogesterone,
estradiol) growth hormones (like human growth hormone), and growth
factors (like granulocyte macrophage colony-stimulating factor)
[0091] In an alternative embodiment, the formulations of the
present invention may form non-parenteral depots where the active
agent is slowly released at a body surface. It is especially
important in this embodiment that the pre-formulations of the
invention and/or the liquid crystalline depot compositions formed
therefrom should preferably be bioadhesive. That is to say that the
compositions should coat the surface to which they are applied
and/or upon which they form as appropriate and should remain even
when this surface is subject to a flow of air or liquid and/or
rubbing. It is particularly preferable that the liquid crystalline
depot compositions formed should be stable to rinsing with water.
For example, a small volume of depot precursor may be applied to a
body surface and be exposed to a flow of five hundred times its own
volume of water per minute for 5 minutes. After this treatment, the
composition can be considered bioadhesive if less than 50% of the
bioactive agent has been lost. Preferably this level of loss will
be matched when water equalling 1000 times and more preferably 10
000 times the volume of the composition is flowed past per minute
for five, or preferably 10, minutes.
[0092] Although the non-parenteral depot compositions of the
present invention may absorb some or all of the water needed to
form a liquid crystalline phase structure from the biological
surfaces with which they are contacted, some additional water may
also be absorbed from the surrounding air. In particular, where a
thin layer of high surface area is formed then the affinity of the
composition for water may be sufficient for it to form a liquid
crystalline phase structure by contact with the water in the air.
The "aqueous fluid" are referred to herein is thus, at least
partially, air containing some moisture in this embodiment.
[0093] Non-parenteral depot compositions will typically be
generated by applying the pre-formulation topically to a body
surface or to a natural or artificially generated body cavity
and/or to the surface of an implant. This application may be by
direct application of liquid such as by spraying, dipping, rinsing,
application from a pad or ball roller, intra-cavity injection (e.g
to an open cavity with or without the use of a needle), painting,
dropping (especially into the eyes) and similar methods. A highly
effective method is aerosol or pump spraying and evidently this
requires that the viscosity of the pre-formulation be as low as
possible and is thus highly suited to the compositions of the
invention. Non-parenteral depots may, however, be used to
administer systemic agents e.g. transmucosally or
transdermally.
[0094] Non-parenteral depots may also be used for application to
surfaces, particularly of implants and materials which will be in
contact with the body or a body part or fluid. Devices such as
implants, catheters etc. may thus be treated e.g. by dipping or
spraying with the preformulations of the invention, which will form
a robust layer to reduce the introduction of infection.
Anti-infective actives are particularly suited to this aspect.
[0095] Conditions particularly suitable for causative or
symptomatic treatment by topical bioadhesive depot compositions of
the present invention include skin conditions (such as soreness
resulting from any cause including chapping, scratching and skin
conditions including eczema and herpes) eye conditions, genital
soreness (including that due to genital infection such as genital
herpes), infections and conditions for the finger and/or toe nails
(such as bacterial or fungal infections of the nails such as
onychomycosis or poronychia). Topical-type bioadhesive formulations
may also be used to administer systemic active agents (e.g.
medication), particularly by skin adsorption, oral, transdermal or
rectal routes. Travel sickness medication is a preferred example,
as is nicotine (e.g. in anti-smoking aids). Where context permits,
"topical application" as referred to herein includes systemic
agents applied non-parenterally to a specific region of the
body.
[0096] Periodontal infections are particularly suitable for
treatment by the compositions of the present invention. In
particular, known compositions for treating periodontal infection
are difficult to apply or are generally ineffective. The most
widely used periodontal depot composition comprises insertion of a
collagen "chip" into the periodontal space, from which an
anti-infective agent is released. This chip is difficult to insert
and does not form to match the shape and volume of the periodontal
space, so that pockets of infection may remain untreated. In
contrast to this, the compositions of the present invention,
applied as a low viscosity preformulation, can be easily and
quickly injected into the periodontal space and will flow to
conform exactly to that space and fill the available volume. The
compositions then quickly absorb water to form a robust gel which
is resistant to aqueous conditions of the mouth. The only known
previous attempt at such an injectible periodontal treatment relied
on dispersions of relatively high viscosity which were difficult to
apply and were subject to undesirable phase separation. All of
these drawbacks are now addressed in the compositions of the
present invention as described herein. Highly suitable actives for
periodontal administration are antiinfectives, especially
benzydamine, tramadol and chlorhexidine.
[0097] Non-parenteral depot compositions are also of significant
benefit in combination with non-pharmaceutical active agents, such
as cosmetic actives, fragrances, essential oils etc. Such
non-pharmaceutical depots will maintain the important aspects of
bioadhesion and sustained release to provide prolonged cosmetic
effects, but may easily be applied by spraying or wiping. This
additionally applies to agents which have both cosmetic and medical
(especially prophylactic) benefits such as sun-protective agents.
Since the topical depot compositions provide robust, water
resistant barriers which can solubilise high levels of actives,
they are especially suitable for sunscreens and sunblocks in
combination with ultra violet light (UV, e.g. UVa, UVb and/or UVc)
absorbing and/or scattering agents, particularly where high levels
of protection is desirable. The compositions are furthermore highly
biocompatible and may act to moisten and soothe the skin during sun
exposure. Compositions of the invention containing soothing agents
such as aloe vera are also highly suitable for soothing and
moistening application after exposure to sunlight, or to skin which
is dry, inflamed or damaged due to, for example irritation, burning
or abrasion.
[0098] Active agents particularly suited to non-parenteral (e.g.
topical) depot administration, which comprises intra oral, buccal,
nasal, ophthalmic, dermal, vaginal delivery routes, include
antibacterials such as chlorhexidine, chloramphenicol, triclosan,
tetracycline, terbinafine, tobramycin, fusidate sodium, butenafine,
metronidazole (the latter particularly for the (e.g. symtomatic)
treatment of acne rosacea--adult acne or some vaginal infections),
antiviral, including acyclovir, anti infectives such as
bibrocathol, ciprofloxacin, levofloxacin, local analgesics such as
benzydamine, lidocaine, prilocalne, xylocalne, bupivacaine,
analgesics such as tramadol, fentanyl, morphine, hydromorphone,
methadone, oxycodone, codeine, asperine, acetaminophen, NSAIDS such
as ibuprofen, flurbiprofen, naproxene, ketoprofen, fenoprofen,
diclofenac, etodalac, diflunisal, oxaproxin, piroxicam, piroxicam,
indomethansine, sulindac, tolmethin, salysylic acids such as
salisylamide and diflunisal, Cox1 or Cox2 inhibitors such as
celecoxib, rofecoxib or valdecoxib, corticosteroids, anticancer and
immuno stimulating agents (for instance, methylaminolevulinat
hydrocloride, interferon alpha and beta), anticonvulsants (for
instance tiagabine topiramate or gabapentin), hormones (such as
testosterone, and testosterone undecanoate, medroxyprogesterone,
estradiol) growth hormones (like human growth hormone), and growth
factors (like granulocyte macrophage colony-stimulating factor),
immuno suppressants (cyclosporine, sirolimus, tacrolimus), nicotine
and antivirals (e.g. acyclovir).
[0099] Some specific actives found by the inventors to form highly
effective depots of the present invention include the
following:
[0100] For long acting injectable depot products of hydrophilic
active agents; [0101] i. octreotide (or other somatostatin
analogues such as lanreotide for treatment of carcoid and VIP
producing tumours and acromegali). Subcutaneous depots formable,
especially with GDO and PC having a sustained release duration of
more than one month and showing less than 20% octreotide degraded
in one month in water-swollen depot at 37.degree. C. Surprisingly
good stability was observed and found to be better than octreotide
formulated in microspheres. Depot showed less than 5% degradation
in product preformulation over eight weeks at 4.degree. C. [0102]
ii. human growth hormone. For treatment of growth disorders and
growth hormone deficiencies. Subcutaneous depot formable,
especially with GDO and PC having a sustained release duration of
more than two weeks [0103] iii. interferon alpha, for treatment of
cancer and viral infections. Subcutaneous depots formable,
especially with GDO and PC, having a sustained release duration of
more than one month [0104] iv. leuprolide. Depots formable having
continuous delivery (preferably continuous delivery inside
therapeutic window) for minimum of one month.
[0105] For long acting injectable depots of lipophilic/amphiphilic
actives;
[0106] i. risperidone
[0107] ii. olanzapine
[0108] iii. testosterone undecanoate
[0109] Depots i to iii formable having continuous delivery
(preferably continuous delivery inside therapeutic window) for
minimum of two weeks.
[0110] For topical bioadhesive, controlled release products for
intraoral (including buccal & periodontal) administration;
[0111] i. benzydamine (local analgesic, anti inflammatory,) or
other local analgesic, analgesic, anti inflammatory, anti
bacterial, anti fungal or combination thereof. Composition provides
sustained effect at intraoral mucosa, in particular damaged,
sensitised, infected mucosa e.g. in patients suffering from oral
mucositis (induced by e.g. chemo- and radiotherapy). In particular
for treatment of oral mucositis. [0112] ii. tramadol (analgesic).
Provides a composition with sustained systemic analgesic effect.
[0113] iii. chlorhexidine gluconate (antibacterial) for treatment
of periodontal and topical infections. Particularly for long acting
effect in periodontal pocket. Compositions result in depots
releasing chlorhexidine over more than 1 h, preferably more than 6
h, most preferably more than 24 h when applied as a liquid, forming
a bioadhesive gel in situ. Surface gel formation time observed to
be between 1 second. and 5 min.
[0114] Depots i to iii formable having high level of active agent
incorporation and high degree of resistance to washing away.
Preformulations in the form of a liquid administered as spray or
liquid wash/rinse for i and ii and gel-forming liquid for iii,
wherein liquid is applied to periodontal pocket, e.g. by
injection.
[0115] For non-parenteral (e.g. topical or systemic) bioadhesive,
controlled release products for nasal administration; [0116] i.
fentanyl (analgesic) provides rapid onset and sustained duration
analgesia when administered as spray [0117] ii. diazepam (anti
anxiety) provides non-parenteral, nasal depot with systemic effect
giving rapid onset and sustained duration. Administered as a
spray
[0118] For topical bioadhesive, controlled release products for
ophthalmic administration; [0119] i. diclofenac (NSAID) with
sustained duration. Administered as in situ phase forming liquid
[0120] ii. pilocarpine (parasymptomimetic, cholinergic agonist) for
treatment of glaucoma. [0121] iii levocabastine hydrochloride,
ketotifen fumarate providing liquid for eye-dropping to give long
lasting relief from allergic conjunctivitis with long period
between reapplication. [0122] iv Pilocarpine hydrochloride for the
treatment of Sjogrens syndrome. [0123] v dexamethasone,
(corticosteroid) [0124] vi chloramphenicol (primarily
bacteriostatic antiinfective) [0125] vii indomethacin (NSAID)
[0126] Depots i to vii formulated as liquid spray or more
preferably drops for direct application to eye surface and provide
in situ depot formation with high resistance to washing out by
tears and wear from blinking/eye rubbing.
[0127] Other actives suitable for ophthalmic compositions include
Antihistamines, Mast cell stabilizers, Nonsteroidal
anti-inflammatory drugs (NSAIDs), Corticosteroids (e.g. to treat
allergic conjunctivitis), Anti-Glaucoma actives including inflow
suppressing/inhibiting agents (beta blocking agents: timolol,
betaxolol, carteolol, levobunolol, etc., topical carbonic anhydrase
inhibitors: dorzolamide, brinzolamide, sympathomimetics:
epinephrine, dipivefrin, clonidine, apraclonidine, brimonidine),
outflow facilitating agents (parasympathomimetics (cholinergic
agonists): pilocarpine prostaglandin analogues and related
compounds: atanoprost, travoprost, bimatoprost, unoprostone)
[0128] For non-parenteral (e.g. topical or systemic) bioadhesive,
controlled release products for dermatological administration;
[0129] i. acyclovir (antiviral). Composition generates a
bioadhesive, film forming product with sustained duration. Applied
as spray or liquid [0130] ii. testosterone undecanoate (hormone
deficiency). bioadhesive, film forming composition with sustained
duration. May be applied as aerosol- or pump-spray, or as
liquid.
[0131] Particularly suitable applications of dermatological
formulations are anti-infective dermatological bioadhesive depots
for protection in environments where contact with infective agents
likely (e.g. human or veterinary surgery, abattoir work, certain
types of cleaning etc.). Bioadhesive depots generated from
composition of the invention provide robust and sustained
protection for the wearer. The compositions with antiinfective
agents may also be used in situations where skin sterility of the
wearer is important for the health of others, such as for nurses or
doctors visiting multiple patients in hospital, where
cross-infection must be avoided. A prior coating with a composition
of the present invention may serve to provide resistance against
picking up of infectives from one area and thus prevent
transmission to another.
[0132] The pre-formulations of the present invention provide
non-lamellar liquid crystalline depot compositions upon exposure to
aqueous fluids, especially in vivo and in contact with body
surfaces. As used herein, the term "non-lamellar" is used to
indicate a normal or reversed liquid crystalline phase (such as a
cubic or hexagonal phase) or the L3 phase or any combination
thereof. The term liquid crystalline indicates all hexagonal, all
cubic liquid crystalline phases and/or all mixtures thereof.
Hexagonal as used herein indicates "normal" or "reversed" hexagonal
(preferably reversed) and "cubic" indicates any cubic liquid
crystalline phase unless specified otherwise. By use of the
pre-formulations of the present invention it is possible to
generate any phase structure present in the phase-diagram of
components a and b with water. This is because the pre-formulations
can be generated with a wider range of relative component
concentrations than previous lipid depot systems without risking
phase separation or resulting in highly viscous solutions for
injection. In particular, the present invention provides for the
use of phospholipid concentrations above 50% relative to the total
amphiphile content. This allows access to phases only seen at high
phospholipid concentrations, particularly the hexagonal liquid
crystalline phases.
[0133] For many combinations of lipids, only certain non-lamellar
phases exist, or exist in any stable state. It is a surprising
feature of the present invention that compositions as described
herein frequently exhibit non-lamellar phases which are not present
with many other combinations of components. In one particularly
advantageous embodiment, therefore, the present invention relates
to compositions having a combination of components for which an
I.sub.2 and/or L.sub.2 phase region exists when diluted with
aqueous solvent. The presence or absence of such regions can be
tested easily for any particular combination by simple dilution of
the composition with aqueous solvent and study of the resulting
phase structures by the methods described herein.
[0134] In a highly advantageous embodiment, the compositions of the
invention may form an I.sub.2 phase, or a mixed phase including
I.sub.2 phase upon contact with water. The I.sub.2 phase is a
reversed cubic liquid crystalline phase having discontinuous
aqueous regions. This phase is of particular advantage in the
controlled release of active agents and especially in combination
with polar active agents, such as water soluble actives because the
discontinuous polar domains prevent rapid diffusion of the actives.
Depot precursors in the L.sub.2 are highly effective in combination
with an I.sub.2 phase depot formation. This is because the L.sub.2
phase is a so-called "reversed micellar" phase having a continuous
hydrophobic region surrounding discrete polar cores. L.sub.2 thus
has similar advantages with hydrophilic actives.
[0135] In transient stages after contact with body fluid the
composition can comprise multiple phases since the formation of an
initial surface phase will retard the passage of solvent into the
core of the depot, especially with substantial sized
administrations of internal depots. Without being bound by theory,
it is believed that this transient formation of a surface phase,
especially a liquid crystalline surface phase, serves to
dramatically reduce the "burst/lag" profile of the present
compositions by immediately restricting the rate of exchange
between the composition and the surroundings. Transient phases may
include (generally in order from the outside towards the centre of
the depot): H.sub..pi. or L.sub..alpha., I.sub.2, L.sub.2, and
liquid (solution). It is highly preferred that the composition of
the invention is capable forming at least two and more preferably
at least three of these phases simultaneously at transient stages
after contact with water at physiological temperatures. In
particular, it is highly preferred that one of the phases formed,
at least transiently, is the I.sub.2 phase.
[0136] It is important to appreciate that the preformulations of
the present invention are of low viscosity. As a result, these
preformulations must not be in any bulk liquid crystalline phase
since all liquid crystalline phases have a viscosity significantly
higher than could be administered by syringe or spray dispenser.
The preformulations of the present invention will thus be in a
non-liquid crystalline state, such as a solution, L.sub.2 or
L.sub.3 phase, particularly solution or L.sub.2. The L.sub.2 phase
as used herein throughout is preferably a "swollen" L.sub.2 phase
containing greater than 10 wt % of solvent (component c) having a
viscosity reducing effect. This is in contrast to a "concentrated"
or "unswollen" L.sub.2 phase containing no solvent, or a lesser
amount of solvent, or containing a solvent (or mixture) which does
not provide the decrease in viscosity associated with the
oxygen-containing, low viscosity solvents specified herein.
[0137] Upon administration, the pre-formulations of the present
invention undergo a phase structure transition from a low viscosity
mixture to a high viscosity (generally tissue adherent) depot
composition. Generally this will be a transition from a molecular
mixture, swollen L.sub.2 and/or L3 phase to one or more (high
viscosity) liquid crystalline phases such as normal or reversed
hexagonal or cubic liquid crystalline phases or mixtures thereof.
As indicated above, further phase transitions may also take place
following administration. Obviously, complete phase transition is
not necessary for the functioning of the invention but at least a
surface layer of the administered mixture will form a liquid
crystalline structure. Generally this transition will be rapid for
at least the surface region of the administered formulation (that
part in direct contact with air, body surfaces and/or body fluids).
This will most preferably be over a few seconds or minutes (e.g. up
to 30 minutes, preferably up to 10 minutes, more preferably 5
minutes of less). The remainder of the composition may change phase
to a liquid crystalline phase more slowly by diffusion and/or as
the surface region disperses.
[0138] In one preferred embodiment, the present invention thus
provides a pre-formulation as described herein of which at least a
portion forms a hexagonal liquid crystalline phase upon contact
with an aqueous fluid. The thus-formed hexagonal phase may
gradually disperse, releasing the active agent, or may subsequently
convert to a cubic liquid crystalline phase, which in turn then
gradually disperses. It is believed that the hexagonal phase will
provide a more rapid release of active agent, in particular of
hydrophilic active agent, than the cubic phase structure,
especially the I.sub.2 and L.sub.2 phase. Thus, where the hexagonal
phase forms prior to the cubic phase, this will result in an
initial release of active agent to bring the concentration up to an
effective level rapidly, followed by the gradual release of a
"maintenance dose" as the cubic phase degrades. In this way, the
release profile may be controlled.
[0139] Without being bound by theory, it is believed that upon
exposure (e.g. to body fluids), the pre-formulations of the
invention lose some or all of the organic solvent included therein
(e.g. by diffusion and/or evaporation) and take in aqueous fluid
from the bodily environment (e.g. moist air close to the body or
the in vivo environment) such that at least a part of the
formulation generates a non-lamellar, particularly liquid
crystalline phase structure. In most cases these non-lamellar
structures are highly viscous and are not easily dissolved or
dispersed into the in vivo environment and are bioadhesive and thus
not easily rinsed or washed away. Furthermore, because the
non-lamellar structure has large polar, apolar and boundary
regions, it is highly effective in solubilising and stabilising
many types of active agents and protecting these from degradation
mechanisms. As the depot composition formed from the
pre-formulation gradually degrades over a period of days, weeks or
months, the active agent is gradually released and/or diffuses out
from the composition. Since the environment within the depot
composition is relatively protected, the pre-formulations of the
invention are highly suitable for active agents with a relatively
low biological half-life (see above).
[0140] It is an unexpected finding of the present inventors that
the pre-formulations result in a depot composition that have very
little "burst" effect in the active agent release profile. This is
unexpected because it might be expected that the low viscosity
mixture (especially if this is a solution) of the pre-composition
would rapidly lose active agent upon exposure to water. In fact,
pre-formulations of the invention have shown considerably less of
an initial "burst" than previously known polymer-base depot
compositions. This is illustrated in the Examples below and Figures
attached hereto. In one embodiment, the invention thus provides
injectable preformulations and resulting depot compositions wherein
the highest plasma concentration of active after administration is
no more than 5 times the average concentration between 24 hours and
5 days of administration. This ratio is preferably no more than 4
times and most preferably no more than 3 times the average
concentration.
[0141] In an additional aspect of the invention, the topical
compositions may be used to provide a physical barrier on body
surfaces, in the absence of any active agent. In particular,
because of the very high bioadherance of the compositions,
"barrier" coatings formed by spraying or application of liquid may
be formed from the present compositions so as to reduce contact
with potential infective or irritant agents or to reduce soiling of
the body surfaces. The robust nature of the compositions and
resistance to washing provide advantageous characteristics for such
barriers, which could conveniently be applied as a liquid or by
spraying.
[0142] The Invention will now be further illustrated by reference
to the following non-limiting Examples and the attached Figures, in
which;
[0143] FIG. 1 shows the cumulative release of methylene blue (MB)
from a depot formulation comprising PC/GDO/EtOH (45/45/10 wt %)
when injected into excess water;
[0144] FIG. 2 demonstrates the non-linear decrease of
pre-formulation viscosity upon addition of N-methylpyrrolidinone
(NMP) and EtOH;
[0145] FIG. 3 shows the plasma concentration (in rats) of salmon
calcitonin (sCT) after subcutaneous injection of various
PC/GDO/EtOH depot precursors containing 500 .mu.g sCT/g of
formulation;
[0146] FIG. 4 shows the initial in vivo release (up to 48 hours) to
plasma (in rats) of sCT from two different depot formulations
following subcutaneous injection;
[0147] FIG. 5 shows the plasma concentration (in rats) of
octreotide (OCT) following subcutaneous injection of a depot
formulation comprising PC/GDO/EtOH (36/54/10 wt %) containing 5 mg
OCT/g formulation, corresponding to 0.5% drug load.
[0148] FIG. 6 shows the plasma concentration (in rats) of
octreotide (OCT) following subcutaneous injection of a depot
formulation comprising PC/GDO/EtOH (47.5/47.5/5.0 wt %) containing
30 mg OCT/g formulation, corresponding to 3% drug load.
[0149] FIG. 7 displays the in vitro release in excess aqueous phase
of chlorhexidine from a depot formulation comprising PC/GDO/EtOH
(36/54/10 wt %) containing 50 mg chlorhexidine/g of formulation,
corresponding to 5% drug load.
EXAMPLES
Example 1
Availability of Various Liquid Crystalline Phases in the Depot by
Choice of Composition
[0150] Injectable formulations containing different proportions of
phosphatidyl choline ("PC"-Epikuron 200) and glycerol dioleate
(GDO) and with EtOH as solvent were prepared to illustrate that
various liquid crystalline phases can be accessed after
equilibrating the depot precursor formulation with excess
water.
[0151] Appropriate amounts of PC and EtOH were weighed in glass
vials and the mixture was placed on a shaker until the PC
completely dissolved to form a clear liquid solution. GDO was then
added to form an injectable homogenous solution.
[0152] Each formulation was injected in a vial and equilibrated
with excess water. The phase behaviour was evaluated visually and
between crossed polarizes at 25.degree. C. Results are presented in
Table 1.
TABLE-US-00001 TABLE 1 Formulation PC (wt %) GDO (wt %) EtOH (wt %)
Phase in H.sub.2O A 22.5 67.5 10.0 L.sub.2 B 28.8 61.2 10.0 I.sub.2
C 45.0 45.0 10.0 H.sub.II D 63.0 27.0 10.0 H.sub.II/L.sub..alpha.
L.sub.2 = reversed micellar phase I.sub.2 = reversed cubic liquid
crystalline phase H.sub.II = reversed hexagonal liquid crystalline
phase L.sub..alpha. = lamellar phase
Example 2
In Vitro Release of a Water-Soluble Substance
[0153] A water-soluble colorant, methylene blue (MB) was dispersed
in formulation C (see Example 1) to a concentration of 11 mg/g
formulation. When 0.5 g of the formulation was injected in 100 ml
water a stiff reversed hexagonal H.sub..pi. phase was formed. The
absorbency of MB released to the aqueous phase was followed at 664
nm over a period of 10 days. The release study was performed in an
Erlenmeyer flask at 37.degree. C. and with low magnetic
stirring.
[0154] The release profile of MB (see FIG. 1) from the hexagonal
phase indicates that this (and similar) formulations are promising
depot systems. Furthermore, the formulation seems to give a low
initial burst, and the release profile indicates that the substance
can be released for several weeks; only about 50% of MB is released
after 10 days.
Example 3
Viscosity in PC/GDO (6:4) or PC/GDO (3:7) on Addition of Solvent
(EtOH, PG and NMP)
[0155] A mixture of PC/GDO/EtOH was manufactured according to the
method in Example 1. All, or nearly all, of the EtOH was removed
from the mixture with a rotary evaporator (vacuum, 40.degree. C., 1
h) and the resulting solid mixture were weighed in glass vial after
which 2, 5, 10 or 20% of a solvent (EtOH, propylene glycol (PG) or
n-methylpyrrolidone (NMP)) was added. The samples were allowed to
equilibrate several days before the viscosity was measured at a
shear rate of 0.1 s.sup.-1 with a Physica UDS 200 rheometer at
25.degree. C.
[0156] This example clearly illustrates the need for solvent with
certain depot precursors in order to obtain an injectable
formulation (see FIG. 2). The viscosity of solvent-free PC/GDO
mixtures increases with increasing ratio of PC. Systems with low
PC/GDO ratio (more GDO) are injectable with a lower concentration
of solvent.
Example 4
Composition and In Vitro Phase Study
[0157] The formulations were manufactured according to the method
described in Example 1 with compositions according to Table 2. An
active substance (peptide), salmon calcitonin (sCT), was added to
each formulation to a concentration of 500 .mu.g sCT/g formulation.
The formulations were designed as homogenous suspensions for
parenteral administration (mixing required shortly prior to use
since the drug is not completely dissolved in the PC/GDO/EtOH
system).
[0158] The phase study in this example is performed in excess of
rat serum at 37.degree. C. in order to simulate an in vivo
situation. Table 2 shows that the same phases as those in water are
formed (compare Table 1).
TABLE-US-00002 TABLE 2 PC GDO OA (wt %) Phase Formulation (wt %)
(wt %) (wt %) EtOH in rat serum E 18 72 -- 10 L.sub.2 F 36 54 -- 10
I.sub.2 G 34 51 5 10 I.sub.2 H 54 36 -- 10 H.sub.II I 72 18 -- 10
H.sub.II/L.sub..alpha. OA = Oleic Acid
Example 5
Sterile Filtration of Formulations with Reduced Viscosity
[0159] To lower the viscosity with various solvents is sometimes
necessary in order to obtain an injectable formulation and to be
able to administrate the system with a regular syringe (see Example
3). Another important effect from the viscosity-lowering solvent is
that the formulations can be sterile filtrated.
[0160] Formulations E to I in Example 4 were studied in a sterile
filtration test by using a 0.22 .mu.m filter (before addition of
the active substance). Formulations E to H were successfully
filtrated, but formulation I failed since the viscosity was too
high. An aseptic manufacturing procedure was therefore needed for
this formulation.
Example 6
In Vivo Release Study from Depot Formulations Subcutaneously
Administered
[0161] Formulations E to I in Example 4 were used in an in vivo
drug release study in rat. The formulations were administrated
subcutaneously between the scapulae by using a syringe (21G, 0.6
mm.times.30 mm) and the dose of sCT was 500 .mu.g/kg body weight.
The release profile was monitored for a period of 13 days. The sCT
concentration in the rat plasma samples was analysed with
sandwich-type immunoassay using a commercial kit from DSLabs.
[0162] FIG. 3 shows the results (n=4). A pure triglyceride vehicle
based on sesame oil was selected as a lipid reference system.
Example 7
In Vivo Release Study in the Initial Phase
[0163] Formulations F and G as in Example 6 were used in an in vivo
study in rat designed to investigate the initial "burst effect".
From FIG. 4 (n=8) it appears that none of the investigated
formulations has a severe burst effect.
Example 8
Preparation of Depot Precursor Compositions with Various
Solvents
[0164] Depending on composition of the formulation and the nature
and concentration of active substance certain solvents may be
preferable.
[0165] Depot precursor formulations (PC/GDO/solvent (36/54/10))
were prepared by with various solvents; NMP, PG, PEG400,
glycerol/EtOH (90/10) by the method of Example 1. All depot
precursor compositions were homogeneous one phase solutions with a
viscosity that enabled injection through a syringe (23G--i.e. 23
gauge needle; 0.6 mm.times.30 mm). After injecting formulation
precursors into excess water a liquid crystalline phase in the form
of a high viscous monolith rapidly formed with NMP and PG
containing precursors. The liquid crystalline phase had a reversed
cubic micellar (I.sub.2) structure. With PEG400, glycerol/EtOH
(90/10) the viscosification/solidification process was much slower
and initially the liquid precursor transformed to a soft somewhat
sticky piece. The difference in appearance probably reflects the
slower dissolution of PEG400 and glycerol towards the excess
aqueous phase as compared to that of EtOH, NMP and PG.
Example 9
Preparation of Depot Composition Containing Human Growth Hormone
(HGH)
[0166] Human growth hormone (hGH) plays a critical role in
stimulating body growth and development, and is involved in the
production of muscle protein and in the breakdown of fats. A
deficiency of the hormone adversely affects numerous body processes
such as lipid profile, insulin status, physical performance,
bone-mineral density and quality of life. A targeted dose every 2
weeks is estimated at 0.10 to 0.24 mg/kg of body weight.
[0167] 1 ml of a 2 weeks depot formulation precursor was formed by
sequentially mixing 10 mg hGH and 360 mg PC in 0.1 ml NMP. 540 mg
GDO was added to the mixture to obtain a low viscosity depot
formulation precursor. Injecting the formulation precursor into
excess water (syringe 23G; 0.6 mm.times.30 mm) resulted in a
monolithic liquid crystalline phase (I.sub.2 structure).
Example 10
Preparation of Depot Composition Containing a Sparingly Soluble
Active Substance
[0168] Risperidone is an antipsychotic medication agent belonging
to the chemical class of benzisoxazole derivatives. It is a very
strong dopamine blocker (antagonist); ie, it inhibits functioning
of dopamine receptors, it is practically insoluble in water, and it
has log(P)=3.49.
[0169] 1 g of a depot formulation containing 50 mg of risperidone
was prepared by dissolving the active substance in 0.7 g of a
mixture 95% wt in EtOH (99.5%) and 5% wt in acetic acid. 0.34 g PC
and 0.51 g GDO were subsequently dissolved in this solution
followed by solvent reduction to remaining 0.15 g solvent (0.55 g
was evaporated under vacuum). The composition of the final
homogenous and clear depot formulation with 50 mg risperidone was
PC/GDO/solvent/risperidone (32/49/14/5). Injecting the formulation
precursor into excess water (syringe 23G; 0.6 mm.times.30 mm)
resulted in a monolithic liquid crystalline phase (I.sub.2
structure). I.e. the amount of active substance (5%) did not change
monolith formation and phase behavior after exposure to an aqueous
environment.
Example 11
Alternate Preparation of Depot Composition Containing
Risperidone
[0170] A risperidone depot precursor formulation could also be
prepared by using a solvent mixture composed of 90% wt EtOH (99.5%)
and 10% wt in acetic acid.
[0171] 50 mg of risperidone was dissolved in 0.7 g of the solvent
mixture, after which 0.36 g PC and 0.54 g GDO were subsequently
dissolved in this solution. 0.60 g of the solvent mixture was
evaporated under vacuum to a homogenous and clear depot formulation
precursor with 50 mg risperidone (PC/GDO/solvent/risperidone
(34/51/10/5)). Injecting the formulation precursor into excess
water (syringe 23G; 0.6 mm.times.30 mm) resulted in a monolithic
liquid crystalline phase (I.sub.2 structure). I.e. the amount of
active substance (5%) did not change monolith formation and phase
behavior after exposure to an aqueous environment.
Example 12
Temperature Stability of Depot Composition Containing a Sparingly
Soluble Active Substance
[0172] The risperdone depot precursor formulations in examples 10
and 11 were tested for stability against crystallization during
storage. Each formulation was stable at 25.degree. C. for at least
two weeks and at +8.degree. C. for at least one week.
Example 13
Preparation of Depot Composition Containing Benzydamine
[0173] Benzydamine is a non-steroidal antiinflammatory drug and is
extensively used as a topical drug in inflammatory conditions.
[0174] 1 g of a depot formulation containing 1.5 mg benzydamine was
prepared by dissolving the active substance in a mixture of
PC/GDO/EtOH (36/54/10) prepared as described in Example 1. The
depot composition was stable against crystallization during storage
at 25.degree. C. for at least two weeks. Equilibration of the
formulation precursor with excess water resulted in a high viscous
monolithic liquid crystalline phase (I.sub.2 structure).
Example 14
Robustness of the Behaviour of the Formulation Against Variations
in the Excipient Quality
[0175] Depot precursor formulations were prepared with several
different GDO qualities (supplied by Danisco, Dk), Table 3, using
the method of Example 1. The final depot precursors contained 36%
wt PC, 54% wt GDO, and 10% wt EtOH. The appearance of the depot
precursors was insensitive to variation in the quality used, and
after contact with excess water a monolith was formed with a
reversed micellar cubic phase behaviour (I.sub.2 structure).
TABLE-US-00003 TABLE 3 Tested qualities of GDO. GDO Monoglyceride
Diglyceride Triglyceride quality (% wt) (% wt) (% wt) A 10.9 87.5
1.6 B 4.8 93.6 1.6 C 1.0 97.3 1.7 D 10.1 80.8 10.1 E 2.9 88.9 8.2 F
0.9 89.0 10.1
Example 15
Preparation of Depot Composition Containing Saturated PC (Epikuron
200SH)
[0176] Depot precursor formulations were prepared with various
amounts PC comprising saturated hydrocarbon chains by addition of
Epikuron 200SH directly to a mixture of PC/GDO/EtOH, prepared as
for Example 1. The formulations are shown in Table 4. All precursor
formulations were homogenous one phase samples in RT, while they
became more viscous with increasing amount Epikuron 200SH.
Injecting the depot precursor into excess water gave a monolith
comprising a reversed miceller cubic (I.sub.2) structure. Monoliths
formed from samples containing higher amounts of Epikuron 200SH
became turbid, possibly indicating segregation between Epikuron
200SH and the other components upon exposure to water and formation
of the 12 phase.
TABLE-US-00004 TABLE 4 Depot composition containing saturated PC
Saturated PC, PC GDO EtOH Formulation Epikuron 200SH (% wt) (% wt)
(% wt) (% wt) G1 3.9 34.6 51.9 9.6 G2 7.0 33.5 50.2 9.3 G3 14.3
30.8 46.3 8.6
Example 16
Preparation of Depot Precursor being a Dispersion or Solution of
the Peptide Salmon Calcitonin
[0177] By adding 500 .mu.g sCT/g formulation to a solution of
PC/GDO/EtOH (36/54/10), obtained as in Example 1, a dispersion of
sCT was formed.
[0178] In an alternative method, 500 .mu.g sCT was dissolved in
excess of EtOH followed by addition of PC and GDO. The solvent
concentration was then reduced (EtOH evaporation) to form a
homogenous (active drug in solution) formulation. This latter
technique can be used to obtain higher drug loads. Precursor
compositions corresponding to at least 1500 .mu.g dissolved sCT per
gram of the final depot precursor composition could be obtained by
this method.
Example 17
In Vivo Release Study from Depot Formulation Subcutaneously
Administered
[0179] The two sCT compositions described in Example 16 were
administered in an in vivo rat model by subcutaneous injection
(between the scapulae). The first depot precursor having dispersed
sCT was found to give somewhat unstable initial plasma
concentrations, while the second depot precursor, having sCT
dissolved therein, gave much more stable initial plasma levels (see
Table 5).
TABLE-US-00005 TABLE 5 Coefficient of Formulations variation (% CV)
Dispersed: 500 .mu.g sCT/g PC/GDO/EtOH (36/54/10) 32-127 Dissolved:
500 .mu.g sCT/g PC/GDO/EtOH (36/54/10) 20-37
Example 18
Preparation of Depot Composition Containing the Peptide
Octreotide
[0180] Octreotide is an acetate salt of a synthetic octa-peptide
and is similar to the hormone somatostatin. Octreotide decreases
production of substances such as growth hormone, insulin and
glucagons. It is used in treatment of acromegaly, and to reduce
flushing and watery diarrhoea caused by metastatic cancerous tumors
(carcinoid syndrome) or tumors called vasoactive intestinal peptide
tumors (VIPomas).
[0181] 24 mg or 60 mg octreotide was dissolved in 0.1 g EtOH. 0.36
g PC and 0.54 g GDO were subsequently dissolved in this solution
and a depot formulation precursor was obtained. Injecting the
formulation precursor into excess aqueous phase (syringe 23G; 0.6
mm.times.30 mm) resulted in a monolithic liquid crystalline phase
(I.sub.2 structure). I.e. octreotide (2.4% or 6.0%) did not change
monolith formation and phase behaviour after exposure to an aqueous
environment.
[0182] The octreotide depot precursor formulations in this Example
were tested for stability against crystallization during storage.
Each formulation was stable at 4-8.degree. C. for at least two
weeks.
Example 19
In Vivo Release Study from Depot Formulation Containing Octreotide
Subcutaneously Administered
[0183] In an in vivo rat model the drug release of octreotide was
followed during 28 days. The formulations were administered
subcutaneously between the scapulae by using a syringe (23G, 0.6
mm.times.25 mm) The octreotide concentration in the rat plasma was
followed for a period of 28 days (see FIG. 5). The dose was 5 mg/kg
and volume 1 ml/kg corresponding to a drug load of 0.5% octreotide
in the depot formulation precursor (PC/GDO/EtOH (36/54/10)).
[0184] From FIG. 5 (n=3) it appears that the investigated
formulation gives a release profile essentially without a burst
effect.
[0185] FIG. 5 shows Octreotide plasma levels in the rat model
following administration of octreotide formulation precursor (0.5%
in octreotide).
Example 20
Degradation of Depot Formulation in the Rat
[0186] Various volumes (1, 2, 6 ml/kg) of the depot precursor (36%
wt PC, 54% wt GDO, and 10% wt EtOH) were injected in the rat and
were removed again after a period of 14 days. It was found that
substantial amounts of the formulations were still present
subcutaneously in the rat after this time, see Table 6.
TABLE-US-00006 TABLE 6 Mean diameter of depot monolith. Dose
(ml/kg) Mean diameter day 3 (mm) Mean diameter day 14 (mm) 1 (n =
3) 15.8 12.5 2 (n = 3) 18.5 15.3 6 (n = 3) 23.3 19.3
Example 21
In Vitro Study of Formation of Depot Monolith after Injection of
Depot Formulation Precursor Between the Bone and Periostium
[0187] A precursor (36% wt PC, 54% wt GDO, and 10% wt EtOH prepared
as described in Example 1) was injected by syringe between the bone
and periostium. The composition was observed to spread to fill
voids and after uptake of aqueous fluids formed a monolith that was
bioadhesive to both the bone and periostium.
Example 22
Bioadhesive Spray of Depot Precursor Formulation
[0188] A pump spray bottle was found to be a convenient way to
apply the formulation topically, e.g. to the skin or the oral
mucosa.
[0189] A depot precursor formulation prepared as in Example 1 (36%
wt PC, 54% wt GDO, and 10% wt EtOH) was sprayed with a pump spray
bottle onto the skin and oral mucosa. A film with solid mechanical
properties formed shortly after application.
Example 23
Robustness of a Topical Film
[0190] After applying the depot precursor formulation, as described
in Example 22, (36% wt PC, 54% wt GDO, and 10% wt EtOH) to the
skin, the applied formulation was exposed to flushing water (10
L/min) for 10 minutes. The formulation showed excellent bioadhesive
properties and resistance against rinsing and no loss of the
formulation could be discerned.
Example 24
Formation of Cubic Phase with Solid Properties after Exposure of
Depot Precursor Formulation to Air
[0191] After exposing a depot precursor formulation prepared as
described in Example 1 (36% wt PC, 54% wt GDO, and 10% wt EtOH) to
air (RT, relative humidity 40%) for at least 3 hours, a solid cubic
phase was formed. This formation of a cubic phase structure
demonstrates that a topical film will acquire bulk non-lamellar
depot properties after application without the need for direct
exposure to excess aqueous fluid.
Example 25
Formulation to Treat Periodontitis or Perimplantitis
[0192] In order to treat periodontitis or perimplantitis an
antibacterial formulation is injected in the periodontal pocket,
and a prolonged effect of the formulation is normally desired.
[0193] 100 mL of a formulation as prepared in Example 1, with the
addition of the antibiotic chlorohexidine
(PC/GDO/EtOH/chlorhexidine (35/53/10/2)), is injected via a syringe
into a rat peridontal pocket. The injected composition is observed
to transform from the low viscous formulation, and which initially
spreads out to fill voids, to form a solid mass by uptake of
gingival fluids. An antibacterial depot system is thus
provided.
[0194] Chlorhexidine remains at clinically effective levels (MIC
125 .mu.g/ml) in the GCF of the periodontal pockets for over 1
week. The depot system is completely degraded by enzymes within 7
to 10 days and does not need to be removed.
Example 26
Alternate Antibacterial Formulation to Treat Periodontitis or
Perimplantitis
[0195] An alternate antibacterial formulation was provided by a
formulation prepared as described in Example 1 and containing the
antibacterial detergent Gardol (Glycine,
N-methyl-N-(1-oxododecyl)-, sodium salt) (PC/GDO/EtOH/Gardol
(34/51/10/5)). This formulation is injected into the rat
periodontal pocket.
[0196] Gardol is observed to remain at clinically effective levels
in the GCF of the periodontal pockets for a prolonged period
(several days). The depot system is completely degraded by enzymes
within 7 to 10 days and did not need to be removed.
Example 27
Adhesion of the Formulation to High Energy Surfaces
[0197] In order to treat perimplantitis, adhesion not only to
biological surfaces but also to high energy surfaces such as a gold
or titanium implant is important. It is also important that the
formulation adheres to ceramic and plastic surfaces.
[0198] A formulation (PC/GDO/EtOH (36/54/10)) as prepared in
Example 1 was applied to various surfaces in the oral cavity. The
composition showed excellent adhesion to ceramic, plastic, gold, as
well as to a normal tooth surface and could not be rinsed away by
excess aqueous fluid. The depot resulting from the composition
stayed at the site in the oral cavity where it was applied for at
least 6 h.
Example 28
Bioadhesive Sustained Release Formulation of Sodium Fluoride for
Use on the Teeth
[0199] Fluoride containing compounds are often needed to oppose
caries attack and a bioadhesive formulation precursor with depot
effect was prepared as indicated in Example 1 from a mixture of
PC/GDO/EtOH/sodium fluoride (35/53/10/2). The formulation was a
dispersion of sodium fluoride since it could not be dissolved in
the precursor. The liquid formulation was applied to the teeth with
the aid of a brush. By uptake of saliva the formulation solidified
and formed a depot providing sustained release of sodium fluoride
for an extended period (several hours).
Example 29
Oral Cavity Spray Depot Composition
[0200] To be suitable as a topical depot system in the oral cavity
the mechanical properties of the system was adjusted by decreasing
the PC/GDO ratio.
[0201] A mixture containing PC/GDO/EtOH (27/63/10) was prepared
according to Example 1. A drop of patent blue was added to
visualize the formulation after application. About 300 .mu.l of the
formulation was sprayed into the oral cavity with pump spray
bottle. Shortly after application the formulation
viscosified/solidified since it underwent a phase transformation by
uptake of aqueous fluid (saliva) and loss of solvent (EtOH). The
formulation had excellent bioadhesion to keritinized surfaces such
as the hard palate and the gum. Here the film lasted for several
hours despite saliva secretion and mechanical wear by the tongue.
At soft mucosal surfaces the duration was much shorter
(minutes).
Example 30
Oral Cavity Liquid Depot Composition
[0202] To be suitable for application with a pipette to the oral
cavity the solidification/viscosification of the formulation has to
be delayed relative to the spray formulation. This is to allow the
formulation to be conveniently distributed with the tongue to a
thin film in the oral cavity after application.
[0203] Propylene glycol (PG) and EtOH were added to a formulation
prepared as in Example 1, to the final composition PC/GDO/EtOH/PG
(24/56/10/10). 300 .mu.l of the formulation was conveniently
applied with a pipette to the oral cavity and distributed with the
tongue to a thin film in the oral cavity. After about 20 seconds
the viscosification of the formulation started since it underwent a
phase transformation by uptake of aqueous fluid (saliva) and loss
of solvent (EtOH and PG). After about one minute the
solidification/viscosification appeared to be finished. The
formulation had excellent bioadhesion to keritinized surfaces such
as the hard palate and the gum. Here the film lasted for several
hours despite saliva secretion and mechanical wear by the tongue.
At soft mucosal surfaces the duration was much shorter
(minutes).
Example 31
Bioadhesive Depot for Nails
[0204] The mixture in Example 29 was sprayed to the nail bed and in
between the toes. The formulation solidifies/viscosifies slowly by
uptake of aqueous fluids (cf. sweat). The solidification can be
speeded up by adding water after spray application. The formulation
had excellent bioadhesive properties and had a duration for several
hours.
Example 32
Loading Capacity of the Bioactive Agent Benzydamine in the
Formulation Precursors
[0205] Formulations with compositions as specified in Table 7 were
prepared using the method in Example 1. An excess amount of
benzydamine (50 mg) was added to 0.5 g of the formulations. The
vials were placed on a shaker at 15.degree. C. for three days after
which the solutions were filtered through a filter (0.45 nm) to get
rid of crystals of undissolved benzydamine. The benzydamine
concentration in each formulation was determined with reversed
phase gradient HPLC and UV detection at 306 nm and the results are
given in Table 7.
TABLE-US-00007 TABLE 7 Composition GDO/ Benzydamine concentration
PC(Lipoid S100)/EtOH in formulation 67.5/22.5/10 3.4% 63/27/10 3.2%
58.5/31.5/10 3.3% 60/20/20 4.0% 56/24/20 4.5% 52/28/20 4.3%
Example 33
Compositions Containing PC and Tocopherol
[0206] Depot precursor formulations were prepared with several
different PC/.alpha.-tocopherol compositions using the method of
Example 1 (PC was first dissolved in the appropriate amount of EtOH
and thereafter .alpha.-tocopherol was added to give clear
homogenous solutions).
[0207] Each formulation was injected in a vial and equilibrated
with excess water. The phase behaviour was evaluated visually and
between crossed polarizes at 25.degree. C. Results are presented in
Table 8.
TABLE-US-00008 TABLE 8 .alpha.- tocopherol PC Ethanol Phase in
excess H.sub.2O 2.25 g 2.25 g 0.5 g H.sub.II 2.7 g 1.8 g 0.5 g
H.sub.II/I.sub.2 3.15 g 1.35 g 0.5 g I.sub.2 3.6 g 0.9 g 0.5 g
I.sub.2/L.sub.2
Example 34
Composition Containing Octreotide
[0208] 60 mg octreotide was dissolved in 0.1 g EtOH. 0.25 g PC and
0.59 g .alpha.-tocopherol were subsequently dissolved in this
solution and a depot formulation precursor was obtained. Injecting
the formulation precursor into excess aqueous solution (phosphate
buffered saline--PBS) resulted in a monolithic liquid crystalline
phase (I.sub.2 structure) i.e. octreotide (6.0%) did not change
monolith formation and phase behaviour after exposure to an aqueous
environment.
[0209] The octreotide depot precursor formulation in this Example
was tested for stability against crystallization during storage.
The formulation was stable at 4-8.degree. C. for at least two
weeks.
Example 35
In Vitro Release of Water-Soluble Disodium Fluorescein
[0210] A water-soluble colorant, disodium fluorescein (Fluo), was
dissolved in a formulation containing PC/.alpha.-tocopherol/Ethanol
(27/63/10 wt %) to a concentration of 5 mg Fluo/g formulation. When
0.1 g of the formulation was injected in 2 ml of phosphate buffered
saline (PBS) a reversed micellar (I.sub.2) phase was formed. The
absorbency of Fluo released to the aqueous phase was followed at
490 nm over a period of 3 days. The release study was performed in
a 3 mL vial capped with an aluminium fully tear off cap at
37.degree. C. The vial was placed on a shaking table at 150
rpm.
[0211] The release of Fluo from the PC/.alpha.-tocopherol
formulation (see Table 9) indicates that this (and similar)
formulations are promising depot systems. Furthermore, the absence
of a burst effect is noteworthy, and the release indicates that the
substance can be released for several weeks to months; only about
0.4% of Fluo is released after 3 days.
TABLE-US-00009 TABLE 9 % release (37.degree. C.) Formulation 24 h
72 h PC/.alpha.-tocopherol/EtOH: <0.1* 0.43 27/63/10 wt %
*Release below detection limit of the absorbance assay
Example 36
Formulations of the Analgesic/Antiinflammatory Benzydamine
[0212] Formulations were prepared as in Example 1 by mixing
benzydamine with a mixture of GDO, PC, ethanol and optionally PG/AP
in the following proportions.
TABLE-US-00010 Formulation BZD GDO PC EtOH PG AP 1 3.0 53.3 28.7
10.0 5.0 0.01 2 3.0 53.3 28.7 15.0 0 0.01 3 3.0 57.4 24.6 10.0 5.0
0.01 4 3.0 49.2 32.8 10.0 5.0 0.01 where BZD is benzydamine, EtOH
is ethanol, PC is LIPOID S100 soybean phosphatidylcholine, GDO is
glycerol dioleate, PG is propylene glycol, and AP is ascorbyl
palmitate.
[0213] All formulations are low viscosity liquids which generate
liquid crystalline phase compositions upon exposure to aqueous
conditions.
Example 37
Fentanyl Nasal Formulation
[0214] Formulations were prepared as in Example 1 by mixing the
narcotic analgesic fentanyl with a mixture of GDO, PC, ethanol and
optionally PG in the following proportions.
TABLE-US-00011 Formulation Fentanyl PC GDO EtOH PG 1 0.05 34 51 10
5 2 0.05 36 54 10 -- 3 0.05 42 43 10 5 4 0.05 45 45 10 -- 5 0.15 34
51 10 5 6 0.15 36 54 10 -- 7 0.05 30 45 15 10 8 0.15 30 45 15 10
where EtOH is ethanol, PC is LIPOID S100 soybean
phosphatidylcholine, GDO is glycerol dioleate, and PG is propylene
glycol
[0215] All formulations are low viscosity liquids suitable for
administration by nasal spray, which generate liquid crystalline
phase compositions upon exposure to aqueous conditions.
Example 38
Diazepam Nasal Formulation
[0216] Formulations were prepared as in previous examples by mixing
the benzodiazepine antianxiety agent diazepam with a mixture of
GDO, PC, ethanol and optionally PG in the following
proportions.
TABLE-US-00012 Formulation Diazepam PC GDO EtOH PG 1 5 32 48 10 5 2
5 34 51 10 -- 3 10 37 38 10 5 4 10 40 40 10 -- 5 10 30 45 10 5 6 10
32 48 10 -- 7 10 26 39 15 10 8 10 30 45 15 -- where EtOH is
ethanol, PC is LIPOID S100 soybean phosphatidylcholine, GDO is
glycerol dioleate, and PG is propylene glycol
[0217] All formulations are low viscosity liquids suitable for
administration by nasal spray, which generate liquid crystalline
phase compositions upon exposure to aqueous conditions.
Example 39
Interferon Alpha-2a
[0218] Interferons (IFNs) are used as a treatment for many types of
systemic cancer, often in combination with chemotherapy or
radiation. Recent data suggest that IFN Alpha is a multifunctional
immunomodulatory cytokine with profound effects on the cytokine
cascade including several anti-inflammatory properties. These newly
identified immunoregulatory and anti-inflammatory functions may
also be of importance in treatment of diseases such as chronic
viral hepatitis and help to explain some of the IFN mechanisms.
[0219] A non-aqueous precursor formulation was formed by dissolving
PC (360 mg) and GDO (540 mg) in EtOH (100 mg). Interferon Alpha-2a
(4 mg) was dissolved in water (76 mg) and this solution was
thereafter added to the non-aqueous precursor formulation to form a
depot formulation precursor of low viscosity.
[0220] Injecting the depot precursor into excess water (syringe 23
G; 0.6 mm.times.30 mm) resulted in a monolithic liquid crystalline
phase (I.sub.2 structure).
Example 40
Leuprorelin (Leuprolide)
[0221] Leuprorelin acetate (or leuprolide acetate) is a synthetic
nonapeptide analogue of naturally occurring gonadotropin releasing
hormone (GnRH or LH-RH) that, when given continuously (e.g. as a
depot formulation), inhibits pituitary gonadotropin secretion and
suppresses testicular and ovarion steroidogenesis. Leuprorelin is
used for the treatment of advanced prostate cancer.
[0222] A depot formulation precursor was formed by sequentially
dissolving 22.5 mg leuprorelin acetate and 360 mg PC in 100 mg of
NMP. 540 mg of GDO was added to the mixture yielding a molecular
solution depot formulation precursor of low viscosity. Injecting
the formulation precursor into excess water (syringe 23 G; 0.6
mm.times.30 mm) resulted in a monolithic liquid crystalline phase
(I.sub.2 structure).
Example 41
Alendronate
[0223] Bisphosphonates are structural analogues of pyrophosphates
and have pharmacologic activity specific for bone due to the strong
affinity of bisphosphonates for hydroxyapatite, a major inorganic
component of bone. The compounds are used to treat postmenopausal
osteoporosis, hypercalcemia of malignancy and metastatic bone
disease (MBD).
[0224] A non-aqueous precursor formulation was formed by dissolving
PC (360 mg) and GDO (540 mg) in EtOH (100 mg). Alendronate (12 mg)
was dissolved in water (80 mg) and this solution was thereafter
added to the non-aqueous precursor formulation to form a depot
formulation precursor of low viscosity. Injecting the depot
precursor into excess water (syringe 23 G; 0.6 mm.times.30 mm)
resulted in a monolithic liquid crystalline phase (I.sub.2
structure).
Example 42
Olanzapine
[0225] Olanzapine is a low molecular weight drug used for the
treatment of patients with schizophrenia.
[0226] A depot formulation precursor was formed by sequentially
mixing 50 mg olanzapine, 360 mg PC and 100 mg of EtOH. 540 mg of
GDO was added to the mixture resulting in the final depot
formulation precursor.
[0227] Injecting the formulation precursor into excess water
(syringe 23 G; 0.6 mm.times.30 mm) resulted in a monolithic liquid
crystalline phase (I.sub.2 structure).
Example 43
Acne Formulations with Clindamycin
[0228] Formulations were prepared as in previous examples by mixing
the semisynthetic antibiotic clindamycin (free base or salt) with a
mixture of GDO, PC, ethanol and PG in the following proportions (by
weight).
TABLE-US-00013 Formulation Clindamycin HCl PC GDO EtOH PG 1 1 30 54
10 5 2 2 29 54 10 5 3 1 34 50 10 5 4 2 33 50 10 5
TABLE-US-00014 Formulation Clindamycin base PC GDO EtOH PG 5 1 30
54 10 5 6 2 29 54 10 5 7 1 33 54 2 10 8 2 32 54 2 10
[0229] The resulting preformulations are low viscosity liquids
which, after application resistant to water, sweat, etc. The
formulation are applied locally on the skin as a gel or by spraying
and are bioadhesive with good film-forming properties.
Example 44
Further Examples of Viscosity in PC/GDO Mixtures on Addition of
Co-Solvent
[0230] Mixtures of PC/GDO and co-solvent were prepared according to
the methods of Example 1 and Example 3 in the proportions indicated
in the table below.
[0231] The samples were allowed to equilibrate for several days
before viscosity measurements were performed using a Physica UDS
200 rheometer at 25.degree. C.
TABLE-US-00015 PC/GDO EtOH/ Glycerol/ H.sub.2O/ Viscosity/ Sample
(wt/wt) wt % wt % wt % mPas 1 50/50 3 -- -- 1900 2 50/50 5 -- --
780 3 50/50 7 -- -- 430 4 50/50 8 -- -- 300 5 50/50 10 -- -- 210 6
50/50 15 -- -- 100 7 45/55 3 -- -- 1350 8 45/55 5 -- -- 540 9 45/55
7 -- -- 320 10 45/55 8 -- -- 250 11 45/55 10 -- -- 150 12 45/55 15
-- -- 85 13 40/60 3 -- -- 740 14 40/60 5 -- -- 400 15 40/60 7 -- --
240 16 40/60 8 -- -- 200 17 40/60 10 -- -- 130 18 40/60 15 -- -- 57
19 40/60 -- 10 -- 8*10.sup.6 20 40/60 -- -- 3 2.5*10.sup.8 21 40/60
-- -- 5 4*10.sup.7
[0232] This example further illustrates the need for a solvent with
viscosity lowering properties in order to obtain injectable
formulations. The mixtures containing glycerol (sample 19) or water
(samples 20 and 21) are too viscous to be injectable at solvent
concentrations equivalent to the samples containing EtOH (compare
with samples 13, 14 and 17).
Example 45
Occtreotide Formulation Compositions
[0233] Formulations were prepared as in Example 1 by mixing the
peptide active octreotide with a mixture of GDO (at one of several
purity levels) or tocopherol, PC, ethanol and optionally dioleoyl
PG in the following proportions (by weight)
TABLE-US-00016 For- mula- tion OCT EtOH PC GDO1 GDO2 GDO3 TP DOPG E
2 10 35.2 -- -- 52.8 -- -- F 2 10 35.2 52.8 -- -- -- -- G 2 10 35.2
-- 52.8 -- -- -- H 2 10 26.4 -- -- -- 61.6 -- I 1 10 35.6 53.4 --
-- -- -- J 2 5 37.2 -- -- 55.8 -- -- K 3 5 36.8 -- -- 55.2 -- -- L
6 5 35.6 -- -- 53.5 -- -- M 3 5 35.8 -- -- 55.2 -- 1 N 3 5 33.8 --
-- 55.2 -- 3 O 3 5 30.8 -- -- 55.2 -- 6 P 3 5 46 -- -- 46 -- -- Q 3
10 43.5 -- -- 43.5 -- -- R 6 10 42 -- -- 42 -- -- S 3 7 45 -- -- 45
-- -- T 6 7 43.5 -- -- 43.5 -- --
[0234] where OCT is octreotide, EtOH is ethanol, PC is LIPOID S100
soybean phosphatidylcholine, GDO is glycerol dioleate, TP is
.alpha.-tocopherol, DOPG is dioleoyl phosphatidylglycerol
[0235] GDO Quality (According to AC)
TABLE-US-00017 Monoglycerides Diglycerides Triglycerides GDO1 10.9%
87.5% 1.4% GDO2 4.2% 92.1% 3.5% GDO3 0.5% 95.3% 4.0%
[0236] Formulation P (for composition see above) was administered
by s.c.injection in the rat at a level of 1 ml formulation per kg
body weight, corresponding to 30 mg/kg of octreotide.
[0237] Octreotide plasma levels after administration were monitored
for 5 days to examine any burst profile. It was observed that the
highest plasma concentration was less than three fold greater than
the average plasma concentration over the first 5 days.
[0238] The results of the study are shown in FIG. 6
Example 46
Sunscreen Formulations
[0239] Formulations were prepared as in Example 1 by mixing each of
several UV absorbing/scattering agents with a mixture of GDO, PC,
and ethanol in the following proportions (by weight)
TABLE-US-00018 Formu- Tioveil Spectraveil Solaveil Tioveil 50
lation PC GDO EtOH CM FIN CT-100 MOTG 1 38 42 5 -- -- -- 15 2 38 42
5 -- -- 15 -- 3 37 38 5 15 5 -- --
[0240] Where TIOVEIL CM (Uniqema) comprises Cyclomethicone (and)
Titanium Dioxide (and) Dimethicone Copolyol (and) Aluminium
Stearate (and) Alumina, SPECTRAVEIL FIN (Uniqema) comprises Zinc
Oxide (and) C12-15 Alkyl Benzoate (and) Polyhydroxystearic Acid,
SOLAVEIL CT-100 (Uniqema) comprises C12-15 Alkyl Benzoate (and)
Titanium Dioxide (and) Polyhydroxystearic Acid (and) Aluminum
Stearate (and) Alumina, and TIOVEIL 50 MOTG (Uniqema) comprises
Titanium Dioxide (and) Caprylic/Capric Triglyceride (and) Mineral
Oil (and) Polyhydroxystearic Acid (and) Aluminum Stearate (and)
Alumina.
[0241] The resulting formulation precursors show low viscosity upon
formulation and are readily applied by pump spray. Upon contact
with body surfaces a resilient UV protective layer is formed.
Example 47
Chlorhexidine Periodontal Depots
[0242] Formulations were prepared as in Example 1 by mixing the
antiinfective agent chlorhexidine digluconate with a mixture of
GDO, PC, and ethanol in the following proportions (by weight)
TABLE-US-00019 TABLE Chlorhexidine digluconate depot formulation
compositions. Chlorhexidine Formulation digluconate PC GDO EtOH A 5
34 51 10 B 5 36 54 5 C 7 33 50 10 D 10 32 48 10 E 15 30 45 10
[0243] The chlorhexidine depot preformulations have low viscosity
and are easily administered to the periodontal pocket. The
compositions provide better distribution and spreading of the
active substance throughout the periodontal pocket when compared to
current products, such as Periochip.RTM..
[0244] The depot formed after application gives protection against
re-infection of the pocket. The depot also has excellent
bioadhesive properties and sticks to mucosal, teeth and bone
surfaces.
[0245] Release of chlorhexidine digluconate from 250 mg Formulation
A (see above) in 0.9% aqueous NaCl (500 ml) was studdied. The
formulation was held in a cylindrical metal cup which was placed in
a teflon holder at the bottom of a standard USP release bath. The
contact area between the formulation and surrounding saline
solution was 2.4 cm.sup.2, and the solution was stirred by paddle
at 100 rpm.
[0246] The release curve shown in FIG. 7 demonstrates the sustained
and essentially uniform release of chlorhexidine from the
formulation over a period of 24 hours.
* * * * *